Methods and products for nucleic acid production and delivery

ABSTRACT

The present invention relates in part to nucleic acids, including nucleic acids encoding proteins, therapeutics and cosmetics comprising nucleic acids, methods for delivering nucleic acids to cells, tissues, organs, and patients, methods for inducing cells to express proteins using nucleic acids, methods, kits and devices for transfecting, gene editing, and reprogramming cells, and cells, organisms, therapeutics, and cosmetics produced using these methods, kits, and devices. Methods and products for altering the DNA sequence of a cell are described, as are methods and products for inducing cells to express proteins using synthetic RNA molecules, including cells present in vivo. Therapeutics comprising nucleic acids encoding gene-editing proteins are also described.

PRIORITY

The present application claims priority to U.S. Provisional ApplicationNo. 61/934,397, filed on Jan. 31, 2014, U.S. Provisional Application No.62/038,608, filed on Aug. 18, 2014, and U.S. Provisional Application No.62/069,667, filed on Oct. 28, 2014, the entire contents of which arehereby incorporated by reference in their entireties.

The present application is related to U.S. application Ser. No.13/465,490, filed on May 7, 2012, International Application No.PCT/US2012/067966, filed on Dec. 5, 2012, U.S. application Ser. No.13/931,251, filed on Jun. 28, 2013, and International Application No.PCT/US2013/068118, filed on Nov. 1, 2013, the entire contents of whichare hereby incorporated by reference in their entireties.

FIELD OF THE INVENTION

The present invention relates, in part, to methods, compositions, andproducts for producing and delivering nucleic acids to cells, tissues,organs, and patients, methods for expressing proteins in cells, tissues,organs, and patients, and cells, therapeutics, and cosmetics producedusing these methods, compositions, and products.

DESCRIPTION OF THE TEXT FILE SUBMITTED ELECTRONICALLY

The contents of the text file submitted electronically herewith areincorporated herein by reference in their entirety: A computer readableformat copy of the Sequence Listing (filename: FAB-008PCSequenceListing.txt; date recorded: Jan. 30, 2015; file size: 929 KB).

BACKGROUND Synthetic RNA and Nucleic-Acid Therapeutics

Ribonucleic acid (RNA) is ubiquitous in both prokaryotic and eukaryoticcells, where it encodes genetic information in the form of messengerRNA, binds and transports amino acids in the form of transfer RNA,assembles amino acids into proteins in the form of ribosomal RNA, andperforms numerous other functions including gene expression regulationin the forms of microRNA and long non-coding RNA. RNA can be producedsynthetically by methods including direct chemical synthesis and invitro transcription, and can be administered to patients for therapeuticuse. However, previously described synthetic RNA molecules are unstableand trigger a potent innate-immune response in human cells. In addition,methods for efficient non-viral delivery of nucleic acids to patients,organs, tissues, and cells in vivo have not been previously described.The many drawbacks of existing synthetic RNA technologies and methodsfor delivery of nucleic acids make them undesirable for therapeutic orcosmetic use.

Cell Reprogramming and Cell-Based Therapies

Cells can be reprogrammed by exposing them to specific extracellularcues and/or by ectopic expression of specific proteins, microRNAs, etc.While several reprogramming methods have been previously described, mostthat rely on ectopic expression require the introduction of exogenousDNA, which can carry mutation risks. DNA-free reprogramming methodsbased on direct delivery of reprogramming proteins have been reported.However, these methods are too inefficient and unreliable for commercialuse. In addition, RNA-based reprogramming methods have been described(See, e.g., Angel. MIT Thesis. 2008. 1-56; Angel et al. PLoS ONE. 2010.5, 107; Warren et al. Cell Stem Cell. 2010. 7, 618-630; Angel. MITThesis. 2011. 1-89; and Lee et al. Cell. 2012. 151, 547-558; thecontents of all of which are hereby incorporated by reference). However,existing RNA-based reprogramming methods are slow, unreliable, andinefficient when performed on adult cells, require many transfections(resulting in significant expense and opportunity for error), canreprogram only a limited number of cell types, can reprogram cells toonly a limited number of cell types, require the use ofimmunosuppressants, and require the use of multiple human-derivedcomponents, including blood-derived HSA and human fibroblast feeders.The many drawbacks of previously disclosed RNA-based reprogrammingmethods make them undesirable for in vivo use.

Gene Editing

Several naturally occurring proteins contain DNA-binding domains thatcan recognize specific DNA sequences, for example, zinc fingers (ZFs)and transcription activator-like effectors (TALEs). Fusion proteinscontaining one or more of these DNA-binding domains and the cleavagedomain of Fokl endonuclease can be used to create a double-strand breakin a desired region of DNA in a cell (See, e.g., US Patent Appl. Pub.No. US 2012/0064620, US Patent Appl. Pub. No. US 2011/0239315, U.S. Pat.No. 8,470,973, US Patent Appl. Pub. No. US 2013/0217119, U.S. Pat. No.8,420,782, US Patent Appl. Pub. No. US 2011/0301073, US Patent Appl.Pub. No. US 2011/0145940, U.S. Pat. No. 8,450,471, U.S. Pat. No.8,440,431, U.S. Pat. No. 8,440,432, and US Patent Appl. Pub. No.2013/0122581, the contents of all of which are hereby incorporated byreference). However, current methods for gene editing cells areinefficient and carry a risk of uncontrolled mutagenesis, making themundesirable for both research and therapeutic use. Methods for DNA-freegene editing of somatic cells have not been previously explored, norhave methods for simultaneous or sequential gene editing andreprogramming of somatic cells. In addition, methods for directly geneediting cells in patients (i.e., in vivo) have not been previouslyexplored, and the development of such methods has been limited by a lackof acceptable targets, inefficient delivery, inefficient expression ofthe gene-editing protein/proteins, inefficient gene editing by theexpressed gene-editing protein/proteins, due in part to poor binding ofDNA-binding domains, excessive off-target effects, due in part tonon-directed dimerization of the Fokl cleavage domain and poorspecificity of DNA-binding domains, and other factors. Finally, the useof gene editing in anti-bacterial, anti-viral, and anti-cancertreatments has not been previously explored.

Accordingly, there remains a need for improved methods and compositionsfor the production and delivery of nucleic acids to cells, tissues,organs, and patients.

SUMMARY OF THE INVENTION

The present invention provides, in part, compositions, methods,articles, and devices for delivering nucleic acids to cells, tissues,organs, and patients, methods for inducing cells to express proteins,methods, articles, and devices for producing these compositions,methods, articles, and devices, and compositions and articles, includingcells, organisms, cosmetics and therapeutics, produced using thesecompositions, methods, articles, and devices. Unlike previously reportedmethods, certain embodiments of the present invention do not involveexposing cells to exogenous DNA or to allogeneic or animal-derivedmaterials, making products produced according to the methods of thepresent invention useful for therapeutic and cosmetic applications.

In some aspects, there is provided a method for expressing a protein ina cell population of a patient, comprising introducing an RNA into thecell population, the RNA comprising one or more non-canonicalnucleotides that do not induce significant cellular immune response anddo not substantially reduce protein expression. In some embodiments, atleast 50%, or at least 75%, or at least 90% of the non-canonicalnucleotides are selected from one or more of 5-hydroxycytidine,5-hydroxymethylcytidine, 5-carboxycytidine, 5-formylcytidine,5-hydroxyuridine, 5-hydroxymethyluridine, 5-carboxyuridine, and5-formyluridine, or in some embodiments selected from one or more of5-hydroxymethylcytidine, 5-carboxycytidine, and 5-formylcytidine.Further embodiments relate to additional elements of the RNA, e.g. a 5′cap structure, a 3′ poly(A) tail, and 5′-UTR and/or 3′-UTR, whichoptionally comprises one or more of a Kozak consensus sequence, asequence that increases RNA stability in vivo (such as, by way ofillustration, an alpha-globin or beta-globin 5′-UTR).

In some aspects, nucleic acid delivery patches are provided. In oneaspect, devices for delivering nucleic acids using electric fields areprovided. Other aspects pertain to methods and compositions for deliveryof nucleic acids to the skin. Still further aspects pertain to methodsand compositions for expression of proteins in the skin.

In one aspect, the invention provides methods and compositions fortreating diseases and conditions in humans, including, but not limitedto, prophylactic treatments, treatments for rare diseases, including,but not limited to, dermatologic rare diseases, and treatments for usein medical dermatology and aesthetic medicine. In another aspect, theinvention provides cosmetics comprising nucleic acids. Still furtheraspects relate to methods and compositions for altering pigmentation,for example, for the treatment of pigmentation disorders. Still furtheraspects relate to methods and compositions for enhancing healing,including, but not limited to, healing in response to a wound orsurgery. Other aspects relate to nucleic acids comprising one or morenon-canonical nucleotides. In one aspect, the invention provides nucleicacids comprising, for example, one or more of 5-hydroxycytidine,5-hydroxymethylcytidine, 5-carboxycytidine, 5-formylcytidine,5-hydroxyuridine, 5-hydroxymethyluridine, 5-carboxyuridine, and5-formyluridine, or in some embodiments selected from one or more of5-hydroxymethylcytidine, 5-carboxycytidine, and/or 5-formylcytidine.

The compositions of the present invention may alter, modify and/orchange the appearance of a member of the integumenary system of asubject such as, but not limited, to skin, hair and nails. Suchalteration, modification and/or change may be in the context oftreatment methods and/or therapeutic uses as described herein including,by way of non-limiting example, dermatological treatments and cosmeticsprocedures.

In some aspects, synthetic RNA molecules with low toxicity and hightranslation efficiency are provided. In one aspect, a cell-culturemedium for high-efficiency in vivo transfection, reprogramming, and geneediting of cells is provided. Other aspects pertain to methods forproducing synthetic RNA molecules encoding reprogramming proteins. Stillfurther aspects pertain to methods for producing synthetic RNA moleculesencoding gene-editing proteins.

In one aspect, the invention provides high-efficiency gene-editingproteins comprising engineered nuclease cleavage domains. In anotheraspect, the invention provides high-fidelity gene-editing proteinscomprising engineered nuclease cleavage domains. Other aspects relate tohigh-efficiency gene-editing proteins comprising engineered DNA-bindingdomains. Still further aspects pertain to high-fidelity gene-editingproteins comprising engineered DNA-binding domains. Still furtheraspects relate to gene-editing proteins comprising engineered repeatsequences. Some aspects relate to methods for altering the DNA sequenceof a cell by transfecting the cell with or inducing the cell to expressa gene-editing protein. Other aspects relate to methods for altering theDNA sequence of a cell that is present in an in vitro culture. Stillfurther aspects relate to methods for altering the DNA sequence of acell that is present in vivo.

In some aspects, the invention provides methods for treating cancercomprising administering to a patient a therapeutically effective amountof a gene-editing protein or a nucleic-acid encoding a gene-editingprotein. In one aspect, the gene-editing protein is capable of alteringthe DNA sequence of a cancer associated gene. In another aspect, thecancer-associated gene is the BIRC5 gene. Still other aspects relate totherapeutics comprising nucleic acids and/or cells and methods of usingtherapeutics comprising nucleic acids and/or cells for the treatment of,for example, type 1 diabetes, heart disease, including ischemic anddilated cardiomyopathy, macular degeneration, Parkinson's disease,cystic fibrosis, sickle-cell anemia, thalassemia, Fanconi anemia, severecombined immunodeficiency, hereditary sensory neuropathy, xerodermapigmentosum, Huntington's disease, muscular dystrophy, amyotrophiclateral sclerosis, Alzheimer's disease, cancer, and infectious diseasesincluding hepatitis and HIV/AIDS. In some aspects, the nucleic acidscomprise synthetic RNA. In other aspects, the nucleic acids aredelivered to cells using a virus. In some aspects, the virus is areplication-competent virus. In other aspects, the virus is areplication-incompetent virus.

The details of the invention are set forth in the accompanyingdescription below. Although methods and materials similar or equivalentto those described herein can be used in the practice or testing of thepresent invention, illustrative methods and materials are now described.Other features, objects, and advantages of the invention will beapparent from the description and from the claims. In the specificationand the appended claims, the singular forms also include the pluralunless the context clearly dictates otherwise. Unless defined otherwise,all technical and scientific terms used herein have the same meaning ascommonly understood by one of ordinary skill in the art to which thisinvention belongs.

DETAILED DESCRIPTION OF THE FIGURES

FIG. 1 depicts RNA encoding human elastin protein and containingadenosine, 50% guanosine, 50% 7-deazaguanosine, 60% uridine, 40%5-methyluridine, and 5-methylcytidine, resolved on a denaturingformaldehyde-agarose gel.

FIG. 2 depicts primary adult human dermal fibroblasts transfected withthe RNA of FIG. 1.

FIG. 3 depicts the result of an immunocytochemical analysis of theprimary adult human dermal fibroblasts of FIG. 2 using an antibodytargeting human elastin protein.

FIG. 4 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising cytidine, 5-methylcytidine (“5mC”),5-hydroxymethylcytidine (“5hmC”), 5-carboxycytidine (“5cC”) or5-formylcytidine (“5fC”) and encoding Oct4 protein. Cells were fixed andstained for Oct4 protein 24 hours after transfection.

FIG. 5 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-hydroxymethylcytidine and encoding greenfluorescent protein (“GFP”). Cells were imaged 24 hours aftertransfection.

FIG. 6 depicts a region of the ventral forearm of a healthy, 33year-old, male human subject treated with synthetic RNA comprising5-hydroxymethylcytidine (“5hmC”) and encoding GFP. Arrows indicatefluorescent cells.

FIG. 7 depicts a region of the ventral forearm of a healthy, 33year-old, male patient treated with synthetic RNA comprising5-hydroxymethylcytidine (“5hmC”) and encoding GFP. The top panel showsan untreated area on the same forearm, while the bottom panels show twofields within the treatment area. Fluorescent cells (indicated witharrows) are clearly visible in the bottom panels.

FIG. 8 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-methyluridine and 5-hydroxymethylcytidine andencoding the indicated protein. Cells were fixed and stained usingantibodies targeting the indicated protein 48 hours after transfection.

FIG. 9 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-methyluridine and 5-hydroxymethylcytidine andencoding human tyrosinase. Cells were fixed and stained using anantibody targeting human tyrosinase 24 hours after transfection.

FIG. 10 depicts primary human epidermal melanocytes.

FIG. 11 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-hydroxymethylcytidine and encoding theindicated proteins.

FIG. 12 depicts primary human dermal fibroblasts transfected daily withsynthetic RNA comprising 5-hydroxymethylcytidine and encoding humantyrosinase. The number of transfections are shown above each sample. Thecells were imaged 48 hours after the final transfection.

FIG. 13 depicts primary human dermal fibroblasts transfected daily withsynthetic RNA comprising the indicated nucleotides and encoding humantyrosinase. The cells were imaged 48 hours after transfection.

FIG. 14 depicts IFNB1 expression and pigment production in primary humandermal fibroblasts transfected with synthetic RNA comprising theindicated nucleotides and encoding human tyrosinase. Values arenormalized to the sample transfected with synthetic RNA comprising onlycanonical nucleotides (“A,G,U,C”). GAPDH was used as a loading control.Error bars indicate standard error (n=2).

FIG. 15 depicts expression of the indicated genes, measured as in FIG.14.

FIG. 16 depicts a region of the ventral forearm of a healthy, 33year-old, male human subject treated with synthetic RNA comprising5-methyluridine and 5-hydroxymethylcytidine and encoding humantyrosinase (top panel), and an ephelis on the ventral forearm of thesame subject (bottom panel). The same magnification was used for bothimages.

FIG. 17 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-hydroxymethylcytidine and encoding collagen I(A1) (“+COL1 RNA”). Cells were fixed and stained using an antibodytargeting collagen I between 24 and 72 hours after transfection. Tworepresentative fields are shown for each of: the transfected cells andun-transfected cells (“Neg.”). Arrows indicate extracellular deposits ofcollagen I.

FIG. 18 depicts primary human dermal fibroblasts transfected withsynthetic RNA comprising 5-hydroxymethylcytidine and encoding collagenVII (A1) (“+COL7 RNA”). Cells were fixed and stained using an antibodytargeting collagen I between 24 and 72 hours after transfection. Arepresentative field is shown for each of: the transfected cells andun-transfected cells (“Neg.”).

DETAILED DESCRIPTION OF THE INVENTION

Definitions

By “molecule” is meant a molecular entity (molecule, ion, complex,etc.).

By “RNA molecule” is meant a molecule that comprises RNA.

By “synthetic RNA molecule” is meant an RNA molecule that is producedoutside of a cell or that is produced inside of a cell usingbioengineering, by way of non-limiting example, an RNA molecule that isproduced in an in vitro-transcription reaction, an RNA molecule that isproduced by direct chemical synthesis or an RNA molecule that isproduced in a genetically-engineered E. coli cell.

By “transfection” is meant contacting a cell with a molecule, whereinthe molecule is internalized by the cell.

By “upon transfection” is meant during or after transfection.

By “transfection reagent” is meant a substance or mixture of substancesthat associates with a molecule and facilitates the delivery of themolecule to and/or internalization of the molecule by a cell, by way ofnon-limiting example, a cationic lipid, a charged polymer or acell-penetrating peptide.

By “reagent-based transfection” is meant transfection using atransfection reagent.

By “cell-culture medium” is meant a medium that can be used for cellculture, by way of non-limiting example, Dulbecco's Modified Eagle'sMedium (DMEM) or DMEM+10% fetal bovine serum (FBS), whether or not themedium is used in vitro or in vivo.

By “complexation medium” is meant a medium to which a transfectionreagent and a molecule to be transfected are added and in which thetransfection reagent associates with the molecule to be transfected.

By “transfection medium” is meant a medium that can be used fortransfection, by way of non-limiting example, Dulbecco's ModifiedEagle's Medium (DMEM), DMEM/F12, saline or water, whether or not themedium is used in vitro or in vivo.

By “recombinant protein” is meant a protein or peptide that is notproduced in animals or humans. Non-limiting examples include humantransferrin that is produced in bacteria, human fibronectin that isproduced in an in vitro culture of mouse cells, and human serum albuminthat is produced in a rice plant.

By “lipid carrier” is meant a substance that can increase the solubilityof a lipid or lipid-soluble molecule in an aqueous solution, by way ofnon-limiting example, human serum albumin or methyl-beta-cyclodextrin.

By “Oct4 protein” is meant a protein that is encoded by the POU5F1 gene,or a natural or engineered variant, family-member, orthologue, fragmentor fusion construct thereof, by way of non-limiting example, human Oct4protein (SEQ ID NO: 8), mouse Oct4 protein, Oct1 protein, a proteinencoded by POU5F1 pseudogene 2, a DNA-binding domain of Oct4 protein oran Oct4-GFP fusion protein. In some embodiments the Oct4 proteincomprises an amino acid sequence that has at least 70% identity with SEQID NO: 8, or in other embodiments, at least 75%, 80%, 85%, 90%, or 95%identity with SEQ ID NO: 8. In some embodiments, the Oct4 proteincomprises an amino acid sequence having from 1 to 20 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 8. Or in other embodiments, the Oct4 protein comprises anamino acid sequence having from 1 to 15 or from 1 to 10 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 8.

By “Sox2 protein” is meant a protein that is encoded by the SOX2 gene,or a natural or engineered variant, family-member, orthologue, fragmentor fusion construct thereof, by way of non-limiting example, human Sox2protein (SEQ ID NO: 9), mouse Sox2 protein, a DNA-binding domain of Sox2protein or a Sox2-GFP fusion protein. In some embodiments the Sox2protein comprises an amino acid sequence that has at least 70% identitywith SEQ ID NO: 9, or in other embodiments, at least 75%, 80%, 85%, 90%,or 95% identity with SEQ ID NO: 9. In some embodiments, the Sox2 proteincomprises an amino acid sequence having from 1 to 20 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 9. Or in other embodiments, the Sox2 protein comprises anamino acid sequence having from 1 to 15 or from 1 to 10 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 9.

By “Klf4 protein” is meant a protein that is encoded by the KLF4 gene,or a natural or engineered variant, family-member, orthologue, fragmentor fusion construct thereof, by way of non-limiting example, human Klf4protein (SEQ ID NO: 10), mouse Klf4 protein, a DNA-binding domain ofKlf4 protein or a Klf4-GFP fusion protein. In some embodiments the Klf4protein comprises an amino acid sequence that has at least 70% identitywith SEQ ID NO: 10, or in other embodiments, at least 75%, 80%, 85%,90%, or 95% identity with SEQ ID NO: 10. In some embodiments, the Klf4protein comprises an amino acid sequence having from 1 to 20 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 10. Or in other embodiments, the Klf4 protein comprises anamino acid sequence having from 1 to 15 or from 1 to 10 amino acidinsertions, deletions, or substitutions (collectively) with respect toSEQ ID NO: 10.

By “c-Myc protein” is meant a protein that is encoded by the MYC gene,or a natural or engineered variant, family-member, orthologue, fragmentor fusion construct thereof, by way of non-limiting example, human c-Mycprotein (SEQ ID NO: 11), mouse c-Myc protein, l-Myc protein, c-Myc(T58A) protein, a DNA-binding domain of c-Myc protein or a c-Myc-GFPfusion protein. In some embodiments the c-Myc protein comprises an aminoacid sequence that has at least 70% identity with SEQ ID NO: 11, or inother embodiments, at least 75%, 80%, 85%, 90%, or 95% identity with SEQID NO: 11. In some embodiments, the c-Myc protein comprises an aminoacid having from 1 to 20 amino acid insertions, deletions, orsubstitutions (collectively) with respect to SEQ ID NO: 11. Or in otherembodiments, the c-Myc protein comprises an amino acid sequence havingfrom 1 to 15 or from 1 to 10 amino acid insertions, deletions, orsubstitutions (collectively) with respect to SEQ ID NO: 11.

By “reprogramming” is meant causing a change in the phenotype of a cell,by way of non-limiting example, causing a 3-cell progenitor todifferentiate into a mature 3-cell, causing a fibroblast todedifferentiate into a pluripotent stem cell, causing a keratinocyte totransdifferentiate into a cardiac stem cell, causing the telomeres of acell to lengthen or causing the axon of a neuron to grow.

By “reprogramming factor” is meant a molecule that, when a cell iscontacted with the molecule and/or the cell expresses the molecule, can,either alone or in combination with other molecules, causereprogramming, by way of non-limiting example, Oct4 protein.

By “feeder” is meant a cell that can be used to condition medium or tootherwise support the growth of other cells in culture.

By “conditioning” is meant contacting one or more feeders with a medium.

By “fatty acid” is meant a molecule that comprises an aliphatic chain ofat least two carbon atoms, by way of non-limiting example, linoleicacid, α-linolenic acid, octanoic acid, a leukotriene, a prostaglandin,cholesterol, a glucocorticoid, a resolvin, a protectin, a thromboxane, alipoxin, a maresin, a sphingolipid, tryptophan, N-acetyl tryptophan or asalt, methyl ester or derivative thereof.

By “short-chain fatty acid” is meant a fatty acid that comprises analiphatic chain of between two and 30 carbon atoms.

By “albumin” is meant a protein that is highly soluble in water, by wayof non-limiting example, human serum albumin.

By “associated molecule” is meant a molecule that is non-covalentlybound to another molecule.

By “associated-molecule-component of albumin” is meant one or moremolecules that are bound to an albumin polypeptide, by way ofnon-limiting example, lipids, hormones, cholesterol, calcium ions, etc.that are bound to an albumin polypeptide.

By “treated albumin” is meant albumin that is treated to reduce, remove,replace or otherwise inactivate the associated-molecule-component of thealbumin, by way of non-limiting example, human serum albumin that isincubated at an elevated temperature, human serum albumin that iscontacted with sodium octanoate or human serum albumin that is contactedwith a porous material.

By “ion-exchange resin” is meant a material that, when contacted with asolution containing ions, can replace one or more of the ions with oneor more different ions, by way of non-limiting example, a material thatcan replace one or more calcium ions with one or more sodium ions.

By “germ cell” is meant a sperm cell or an egg cell.

By “pluripotent stem cell” is meant a cell that can differentiate intocells of all three germ layers (endoderm, mesoderm, and ectoderm) invivo.

By “somatic cell” is meant a cell that is not a pluripotent stem cell ora germ cell, by way of non-limiting example, a skin cell.

By “glucose-responsive insulin-producing cell” is meant a cell that,when exposed to a certain concentration of glucose, can produce and/orsecrete an amount of insulin that is different from (either less than ormore than) the amount of insulin that the cell produces and/or secreteswhen the cell is exposed to a different concentration of glucose, by wayof non-limiting example, a β-cell.

By “hematopoietic cell” is meant a blood cell or a cell that candifferentiate into a blood cell, by way of non-limiting example, ahematopoietic stem cell or a white blood cell.

By “cardiac cell” is meant a heart cell or a cell that can differentiateinto a heart cell, by way of non-limiting example, a cardiac stem cellor a cardiomyocyte.

By “retinal cell” is meant a cell of the retina or a cell that candifferentiate into a cell of the retina, by way of non-limiting example,a retinal pigmented epithelial cell.

By “skin cell” is meant a cell that is normally found in the skin, byway of non-limiting example, a fibroblast, a keratinocyte, a melanocyte,an adipocyte, a mesenchymal stem cell, an adipose stem cell or a bloodcell.

By “Wnt signaling agonist” is meant a molecule that can perform one ormore of the biological functions of one or more members of the Wntfamily of proteins, by way of non-limiting example, Wnt1, Wnt2, Wnt3,Wnt3a or2-amino-4-[3,4-(methylenedioxy)benzylamino]-6-(3-methoxyphenyl)pyrimidine.

By “IL-6 signaling agonist” is meant a molecule that can perform one ormore of the biological functions of IL-6 protein, by way of non-limitingexample, IL-6 protein or IL-6 receptor (also known as soluble IL-6receptor, IL-6R, IL-6R alpha, etc.).

By “TGF-β signaling agonist” is meant a molecule that can perform one ormore of the biological functions of one or more members of the TGF-βsuperfamily of proteins, by way of non-limiting example, TGF-β1, TGF-β3,Activin A, BMP-4 or Nodal.

By “immunosuppressant” is meant a substance that can suppress one ormore aspects of an immune system, and that is not normally present in amammal, by way of non-limiting example, B18R or dexamethasone.

By “single-strand break” is meant a region of single-stranded ordouble-stranded DNA in which one or more of the covalent bonds linkingthe nucleotides has been broken in one of the one or two strands.

By “double-strand break” is meant a region of double-stranded DNA inwhich one or more of the covalent bonds linking the nucleotides has beenbroken in each of the two strands.

By “nucleotide” is meant a nucleotide or a fragment or derivativethereof, by way of non-limiting example, a nucleobase, a nucleoside, anucleotide-triphosphate, etc.

By “nucleoside” is meant a nucleotide or a fragment or derivativethereof, by way of non-limiting example, a nucleobase, a nucleoside, anucleotide-triphosphate, etc.

By “gene editing” is meant altering the DNA sequence of a cell, by wayof non-limiting example, by transfecting the cell with a protein thatcauses a mutation in the DNA of the cell.

By “gene-editing protein” is meant a protein that can, either alone orin combination with one or more other molecules, alter the DNA sequenceof a cell, by way of non-limiting example, a nuclease, a transcriptionactivator-like effector nuclease (TALEN), a zinc-finger nuclease, ameganuclease, a nickase, a clustered regularly interspaced shortpalindromic repeat (CRISPR)-associated protein or a natural orengineered variant, family-member, orthologue, fragment or fusionconstruct thereof.

By “repair template” is meant a nucleic acid containing a region of atleast about 70% homology with a sequence that is within 10 kb of atarget site of a gene-editing protein.

By “repeat sequence” is meant an amino-acid sequence that is present inmore than one copy in a protein, to within at least about 10% homology,by way of non-limiting example, a monomer repeat of a transcriptionactivator-like effector.

By “DNA-binding domain” is meant a region of a molecule that is capableof binding to a DNA molecule, by way of non-limiting example, a proteindomain comprising one or more zinc fingers, a protein domain comprisingone or more transcription activator-like (TAL) effector repeat sequencesor a binding pocket of a small molecule that is capable of binding to aDNA molecule.

By “binding site” is meant a nucleic-acid sequence that is capable ofbeing recognized by a gene-editing protein, DNA-binding protein,DNA-binding domain or a biologically active fragment or variant thereofor a nucleic-acid sequence for which a gene-editing protein, DNA-bindingprotein, DNA-binding domain or a biologically active fragment or variantthereof has high affinity, by way of non-limiting example, an about20-base-pair sequence of DNA in exon 1 of the human BIRC5 gene.

By “target” is meant a nucleic acid that contains a binding site.

Other definitions are set forth in U.S. application Ser. No. 13/465,490,U.S. Provisional Application No. 61/664,494, U.S. ProvisionalApplication No. 61/721,302, International Application No.PCT/US12/67966, U.S. Provisional Application No. 61/785,404, U.S.Provisional Application No. 61/842,874, International Application No.PCT/US13/68118, U.S. Provisional Application No. 61/934,397, U.S.application Ser. No. 14/296,220, U.S. Provisional Application No.62/038,608, and U.S. Provisional Application No. 62/069,667, thecontents of which are hereby incorporated by reference in theirentireties.

Glycation and glycosylation are processes by which one or more sugarmolecules are bound to a protein. It has now been discovered thataltering the number or location of glycation and glycosylation sites canincrease or decrease the stability of a protein. Certain embodiments aretherefore directed to a protein with one or more glycation orglycosylation sites. In one embodiment, the protein is engineered tohave more glycation or glycosylation sites than a natural variant of theprotein. In another embodiment, the protein is engineered to have fewerglycation or glycosylation sites than a natural variant of the protein.In yet another embodiment, the protein has increased stability. In yetanother embodiment, the protein has decreased stability.

It has been further discovered that in certain situations, including oneor more steroids and/or one or more antioxidants in the transfectionmedium can increase in vivo transfection efficiency, in vivoreprogramming efficiency, and in vivo gene-editing efficiency. Certainembodiments are therefore directed to contacting a cell or patient witha glucocorticoid, such as hydrocortisone, prednisone, prednisolone,methylprednisolone, dexamethasone or betamethasone. Other embodimentsare directed to a method for inducing a cell to express a protein ofinterest by contacting a cell with a medium containing a steroid andcontacting the cell with one or more nucleic acid molecules. In oneembodiment, the nucleic acid molecule comprises synthetic RNA. Inanother embodiment, the steroid is hydrocortisone. In yet anotherembodiment, the hydrocortisone is present in the medium at aconcentration of between about 0.1 uM and about 10 uM, or about 1 uM.Other embodiments are directed to a method for inducing a cell in vivoto express a protein of interest by contacting the cell with a mediumcontaining an antioxidant and contacting the cell with one or morenucleic acid molecules. In one embodiment, the antioxidant is ascorbicacid or ascorbic-acid-2-phosphate. In another embodiment, the ascorbicacid or ascorbic-acid-2-phosphate is present in the medium at aconcentration of between about 0.5 mg/L and about 500 mg/L, includingabout 50 mg/L. Still other embodiments are directed to a method forreprogramming and/or gene-editing a cell in vivo by contacting the cellwith a medium containing a steroid and/or an antioxidant and contactingthe cell with one or more nucleic acid molecules, wherein the one ormore nucleic acid molecules encodes one or more reprogramming and/orgene-editing proteins. In certain embodiments, the cell is present in anorganism, and the steroid and/or antioxidant are delivered to theorganism.

Adding transferrin to the complexation medium has been reported toincrease the efficiency of plasmid transfection in certain situations.It has now been discovered that adding transferrin to the complexationmedium can also increase the efficiency of in vivo transfection withsynthetic RNA molecules. Certain embodiments are therefore directed to amethod for inducing a cell in vivo to express a protein of interest byadding one or more synthetic RNA molecules and a transfection reagent toa solution containing transferrin. In one embodiment, the transferrin ispresent in the solution at a concentration of between about 1 mg/L andabout 100 mg/L, such as about 5 mg/L. In another embodiment, thetransferrin is recombinant.

Cells, tissues, organs, and organisms, including, but not limited to,humans, have several characteristics that can inhibit or prevent thedelivery of nucleic acids, including, for example, the stratum corneum,which can serve as a barrier to foreign organisms and nucleic acids.These characteristics can thus inhibit the effects of therapeutics andcosmetics comprising nucleic acids. It has now been discovered that manyof these characteristics can be circumvented or overcome using a patchcomprising a flexible membrane and a plurality of needles, and that sucha patch can serve as an effective and safe article for the delivery ofnucleic acids. Certain embodiments are therefore directed to a nucleicacid delivery patch. In one embodiment, the nucleic acid delivery patchcomprises a flexible membrane. In another embodiment, the nucleic aciddelivery patch comprises a plurality of needles. In yet anotherembodiment, the plurality of needles are attached to the flexiblemembrane. In some embodiments, the patch comprises a nucleic acid. Inone embodiment, the nucleic acid is present in solution. In oneembodiment, the plurality of needles include one or more needles havinga lumen. In another embodiment, the patch further comprises a secondflexible membrane. In yet another embodiment, the flexible membrane andthe second flexible membrane are arranged to form a cavity. In a furtherembodiment, the cavity contains a nucleic acid. In a still furtherembodiment, the membrane comprises one or more holes through which anucleic acid can pass. In a still further embodiment, one or more holesand one or more needles having a lumen are arranged to allow the passageof a solution containing a nucleic acid through at least one of the oneor more holes and through at least one of the one or more needles havinga lumen. In some embodiments, the patch is configured to deliver asolution to the skin. In one embodiment, the solution comprises anucleic acid. In another embodiment, the solution comprises a vehicle.In yet another embodiment, the vehicle is a lipid or lipidoid. In astill further embodiment, the vehicle is a lipid-based transfectionreagent.

The cell membrane can serve as a barrier to foreign nucleic acids. Ithas now been discovered that combining the patch of the presentinvention with an electric field can increase the efficiency of nucleicacid delivery. Certain embodiments are therefore directed to a nucleicacid delivery patch comprising a plurality of needles, wherein at leasttwo needles form part of a high-voltage circuit. In one embodiment, thehigh-voltage circuit generates a voltage greater than about 10V. Inanother embodiment, the high-voltage circuit generates a voltage greaterthan about 20V. In yet another embodiment, an electric field is producedbetween two of the needles. In a further embodiment, the magnitude ofthe electric field is at least about 100V/cm. In a still furtherembodiment, the magnitude of the electric field is at least about200V/cm. In some embodiments, the patch is configured to deliver anucleic acid to the epidermis. In other embodiments, the patch isconfigured to deliver a nucleic acid to the dermis. In still otherembodiments, the patch is configured to deliver a nucleic acid tosub-dermal tissue. In still other embodiments, the patch is configuredto deliver a nucleic acid to muscle. Certain embodiments are directed toa nucleic acid delivery patch comprising a plurality of electrodes. Inone embodiment, the plurality of electrodes is attached to a flexiblemembrane. Other embodiments are directed to a nucleic acid deliverypatch comprising a rigid structure. In one embodiment, a plurality ofelectrodes are attached to the rigid structure.

Other embodiments are directed to a method for delivering a nucleic acidto a cell in vivo comprising applying a nucleic acid to a tissuecontaining a cell in vivo. In one embodiment, the method furthercomprises applying a transient electric field in the vicinity of thecell. In another embodiment, the method results in the cell in vivointernalizing the nucleic acid. In yet another embodiment, the nucleicacid comprises synthetic RNA. In a further embodiment, the methodfurther results in the cell internalizing a therapeutically orcosmetically effective amount of the nucleic acid. In one embodiment,the cell is a skin cell. In another embodiment, the cell is a musclecell. In yet another embodiment, the cell is a dermal fibroblast. In afurther embodiment, the cell is a keratinocyte. In a still furtherembodiment, the cell is a myoblast. In some embodiments, the nucleicacid comprises a protein of interest. In one embodiment, the protein ofinterest is a fluorescent protein. In another embodiment, the protein ofinterest is an extracellular-matrix protein. In yet another embodiment,the protein of interest is a member of the group: elastin, collagen,laminin, fibronectin, vitronectin, lysyl oxidase, elastin bindingprotein, a growth factor, fibroblast growth factor, transforming growthfactor beta, granulocyte colony-stimulating factor, a matrixmetalloproteinase, an actin, fibrillin, microfibril-associatedglycoprotein, a lysyl-oxidase-like protein, platelet-derived growthfactor, a lipase, an uncoupling protein, thermogenin, and a proteininvolved with pigment production. In some embodiments, the methodfurther comprises delivering the nucleic acid to the epidermis. In otherembodiments, the method further comprises delivering the nucleic acid tothe dermis. In still other embodiments, the method further comprisesdelivering the nucleic acid below the dermis. In one embodiment, thedelivering is by injection. In another embodiment, the delivering is byinjection using a micro-needle array. In yet another embodiment, thedelivering is by topical administration. In a further embodiment, thedelivering comprises disruption or removal of a part of the tissue. In astill further embodiment, the delivering comprises disruption or removalof the stratum corneum. In some embodiments, the nucleic acid is presentin solution. In one embodiment, the solution comprises a growth factor.In another embodiment, the growth factor is a member of the group: afibroblast growth factor and a transforming growth factor. In yetanother embodiment, the growth factor is a member of the group: basisfibroblast growth factor and transforming growth factor beta. In otherembodiments, the solution comprises cholesterol.

In another embodiment, the method further comprises contacting the cellwith one or more nucleic acid molecules. In yet another embodiment, atleast one of the one or more nucleic acid molecules encodes a protein ofinterest. In a further embodiment, the method results in the cellexpressing the protein of interest. In a still further embodiment, themethod results in the cell expressing a therapeutically or cosmeticallyeffective amount of the protein of interest.

In another embodiment, the cell is contacted with a nucleic acidmolecule. In yet another embodiment, the method results in the cellinternalizing the nucleic acid molecule. In a further embodiment, themethod results in the cell internalizing a therapeutically orcosmetically effective amount of the nucleic acid molecule. In oneembodiment, the nucleic acid encodes a protein of interest. In oneembodiment, the nucleic acid molecule comprises a member of the group: adsDNA molecule, a ssDNA molecule, a dsRNA molecule, a ssRNA molecule, aplasmid, an oligonucleotide, a synthetic RNA molecule, a miRNA molecule,an mRNA molecule, and an siRNA molecule.

Synthetic RNA comprising only canonical nucleotides can bind to patternrecognition receptors, can be recognized as a pathogen-associatedmolecular pattern, and can trigger a potent immune response in cells,which can result in translation block, the secretion of inflammatorycytokines, and cell death. It has now been discovered that synthetic RNAcomprising certain non-canonical nucleotides can evade detection by theinnate immune system, and can be translated at high efficiency intoprotein. It has been further discovered that synthetic RNA comprising atleast one member of the group: 5-hydroxycytidine,5-hydroxymethylcytidine, 5-carboxycytidine, 5-formylcytidine,5-hydroxyuridine, 5-hydroxymethyluridine, 5-carboxyuridine, and5-formyluridine can evade detection by the innate immune system, and canbe translated at high efficiency into protein. Certain embodiments aretherefore directed to a method for inducing a cell to express a proteinof interest comprising contacting a cell with synthetic RNA. Otherembodiments are directed to a method for transfecting a cell withsynthetic RNA comprising contacting a cell with a solution comprisingone or more synthetic RNA molecules. Still other embodiments aredirected to a method for treating a patient comprising administering tothe patient synthetic RNA. In one embodiment, the synthetic RNAcomprises at least one member of the group: 5-hydroxycytidine,5-hydroxymethylcytidine, 5-carboxycytidine, 5-formylcytidine,5-hydroxyuridine, 5-hydroxymethyluridine, 5-carboxyuridine, and5-formyluridine. In another embodiment, the synthetic RNA encodes aprotein of interest. Exemplary RNAs may contain combinations and levelsof non-canonical and non-canonical nucleotides as described elsewhereherein, including with respect to the expression of any protein ofinterest described herein. In yet another embodiment, the method resultsin the expression of the protein of interest. In a further embodiment,the method results in the expression of the protein of interest in thepatient's skin.

It has now been further discovered that contacting a cell with a steroidcan suppress the innate immune response to foreign nucleic acids, andcan increase the efficiency of nucleic acid delivery and translation.Certain embodiments are therefore directed to contacting a cell with asteroid. Other embodiments are directed to administering a steroid to apatient. In one embodiment, the steroid is hydrocortisone. In anotherembodiment, the steroid is dexamethasone. Still other embodiments aredirected to administering to a patient a member of the group: anantibiotic, an antimycotic, and an RNAse inhibitor.

Other embodiments are directed to a method for delivering a nucleic acidto a cell in vivo. Still other embodiments are directed to a method forinducing a cell in vivo to express a protein of interest. Still otherembodiments are directed to a method for treating a patient. In oneembodiment, the method comprises disrupting the stratum corneum. Inanother embodiment, the method comprises contacting a cell with anucleic acid. In yet another embodiment, the method results in the cellinternalizing the nucleic acid. In a further embodiment, the methodresults in the cell expressing the protein of interest. In a stillfurther embodiment, the method results in the expression of the proteinof interest in the patient. In a still further embodiment, the methodresults in the amelioration of one or more of the patient's symptoms. Ina still further embodiment, the patient is in need of the protein ofinterest. In a still further embodiment, the patient is deficient in theprotein of interest.

Still other embodiments are directed to a method for treating a patientcomprising delivering to a patient a composition. In one embodiment, thecomposition comprises albumin that is treated with an ion-exchange resinor charcoal. In another embodiment, the composition comprises one ormore nucleic acid molecules. In yet another embodiment, at least one ofthe one or more nucleic acid molecules encodes a protein of interest. Inone embodiment, the method results in the expression of the protein inthe patient's skin. In another embodiment, the method results in theexpression of a therapeutically or cosmetically effective amount of theprotein of interest in the patient. In yet another embodiment, themethod comprises administering a steroid. In a further embodiment, thesteroid is a member of the group: hydrocortisone and dexamethasone.

Certain embodiments are directed to a synthetic RNA molecule. In oneembodiment, the synthetic RNA molecule encodes a protein of interest. Inanother embodiment, the synthetic RNA molecule comprises a member of thegroup: 5-hydroxycytidine, 5-hydroxymethylcytidine, 5-carboxycytidine,5-formylcytidine, 5-hydroxyuridine, 5-hydroxymethyluridine,5-carboxyuridine, and 5-formyluridine. Other embodiments are directed toa cosmetic composition. In one embodiment, the cosmetic compositioncomprises albumin. In another embodiment, the albumin is treated with anion-exchange resin or charcoal. In yet another embodiment, the cosmeticcomposition comprises a nucleic acid molecule. In a further embodiment,the cosmetic composition comprises both albumin and a nucleic acidmolecule. Still other embodiments are directed to a cosmetic treatmentarticle comprising a cosmetic composition contained in a deviceconfigured to deliver the composition to a patient. Still otherembodiments are directed to a device configured to deliver a cosmeticcomposition to a patient. In one embodiment, the nucleic acid moleculeencodes a member of the group: elastin, collagen, tyrosinase,melanocortin 1 receptor, and hyaluronan synthase.

Certain proteins have long half-lives, and can persist in tissues forseveral hours, days, weeks, months or years. It has now been discoveredthat certain methods of treating a patient can result in accumulation ofone or more proteins, including, for example, one or more beneficialproteins. Certain embodiments are therefore directed to a method fortreating a patient comprising delivering to a patient in a series ofdoses a nucleic acid encoding one or more proteins. In one embodimentthe nucleic acid comprises synthetic RNA. In another embodiment, a firstdose is given at a first time-point. In yet another embodiment, a seconddose is given at a second time-point. In a further embodiment, theamount of at least one of the one or more proteins in the patient at thesecond time-point is greater than the amount of said protein at thefirst time-point. In a still further embodiment, the method results inthe accumulation of said protein in the patient.

Other embodiments are directed to a therapeutic composition comprising anucleic acid molecule encoding one or more proteins, wherein at leastone of the one or more proteins is an extracellular matrix protein.Still other embodiments are directed to a cosmetic compositioncomprising a nucleic acid molecule encoding one or more proteins,wherein at least one of the one or more proteins is an extracellularmatrix protein.

Pigmentation disorders can cause severe symptoms in patients. It has nowbeen discovered that pigmentation disorders can be treated by deliveringto a patient a nucleic acid encoding tyrosinase. Certain embodiments aretherefore directed to a method for treating a pigmentation disorder.Other embodiments are directed to a method for altering the pigmentationof a patient. In one embodiment, the method comprises delivering to apatient a nucleic acid encoding tyrosinase. Other embodiments aredirected to a cosmetic composition comprising a nucleic acid encodingtyrosinase. Still other embodiments are directed to a therapeuticcomposition comprising a nucleic acid encoding tyrosinase. Still otherembodiments are directed to a method for increasing the ultravioletabsorption of a patient's skin. In one embodiment the method comprisesdelivering to a patient a nucleic acid encoding tyrosinase. In anotherembodiment, the method results in an increase in the ultravioletabsorption of the patient's skin. Still other embodiments are directedto a method for reducing photodamage to a person's skin upon exposure toultraviolet light. In one embodiment, the method results in thereduction of photodamage to the person's skin upon exposure toultraviolet light. Still other embodiments are directed to a method fortreating xeroderma pigmentosum. In one embodiment, the method comprisesdelivering to a patient a nucleic acid encoding tyrosinase. Still otherembodiments are directed to a method for treating epidermolysis bullosa.In one embodiment, the method comprises delivering to a patient anucleic acid encoding collagen type VII. In another embodiment, themethod comprises delivering to a patient a nucleic acid encodingmelanocortin 1 receptor. Still other embodiments are directed to amethod for treating xerosis. In one embodiment, the method comprisesdelivering to a patient a nucleic acid encoding a hyaluronan synthase.In another embodiment, the patient is diagnosed with atopic dermatitis.In yet another embodiment, the patient is diagnosed with ichthyosis.Certain embodiments are directed to a method for treating a cosmeticcondition. Other embodiments are directed to a method for inducingtissue healing. In one embodiment, the method comprises delivering to apatient a nucleic acid encoding a hyaluronan synthase. In anotherembodiment, the cosmetic condition is a member of the group: wrinkles,sagging skin, thin skin, discoloration, and dry skin. In yet anotherembodiment, the patient has had cataract surgery. In some embodiments,the nucleic acid is synthetic RNA. In other embodiments, the methodresults in the amelioration of one or more of the patient's symptoms.Other embodiments are directed to a method for treating an indication bydelivering to a cell or a patient a nucleic acid encoding a protein or apeptide. Still other embodiments are directed to a compositioncomprising a nucleic acid encoding a protein or a peptide. Indicationsthat can be treated using the methods and compositions of the presentinvention and proteins and peptides that can be encoded by compositionsof the present invention are set forth in Table 1, and are given by wayof example, and not by way of limitation. In one embodiment, theindication is selected from Table 1. In another embodiment the proteinor peptide is selected from Table 1. In yet another embodiment, theindication and the protein or peptide are selected from the same row ofTable 1. In a further embodiment, the protein of interest is a member ofthe group: UCP1, UCP2, and UCP3. Other embodiments are directed tomethods for inducing a cell to express a plurality of proteins ofinterest. In one embodiment, the proteins of interest include at leasttwo members of the group: a lipase, UCP1, UCP2, and UCP3. In anotherembodiment, the proteins of interest include a lipase and a member ofthe group: UCP1, UCP2, and UCP3. In another embodiment, the protein is agene-editing protein. In yet another embodiment, the gene-editingprotein targets a gene that is at least partly responsible for a diseasephenotype. In yet another embodiment, the gene-editing protein targets agene that encodes a protein selected from Table 1. In still anotherembodiment, the gene-editing protein corrects or eliminates, eitheralone or in combination with one or more other molecules or gene-editingproteins, a mutation that is at least partly responsible for a diseasephenotype.

TABLE 1 Ilustrative Indications Ilustrative Indication IlustrativeProtein/Peptide Acne Retinol Dehydrogenase 10 Aging Elastin AgingCollagen Type I Aging Collagen Type III Aging Collagen Type VII AgingHyaluronan Synthase Aging Telomerase Reverse Transcriptase AlbinismTyrosinase Alport Syndrome Collagen Type IV Anemia Erythropoietin AtopicDermatitis Filaggrin Cutis Laxa Elastin Dystrophic Epidermolysis BullosaCollagen Type VII Ehlers-Danlos Syndrome Collagen Type V Ehlers-DanlosSyndrome Collagen Type I Epidermolysis bullosa, lethal ADAM17acantholytic Epidermolysis bullosa, type IV Collagen Type IIIErythropoietic Protoporphyria Ferrochelatase Excess Fat ThermogeninExcess Fat Lipase Hypotrichosis ADAM17 Ichthyosis Vulgaris FilaggrinInfections Genetic Antibiotics (e.g. Anti-Sigma Factors) Inflammatoryand Bullous Skin Desmoglein 2 Bowel Syndrome Keratosis Pilaris RetinolDehydrogenase 10 Oily Skin Retinol Dehydrogenase 10 OsteoarthritisHyaluronan Synthase Pemphigus Vulgaris Plakophilin-1 Pseudoxanthomaelasticum Elastin Psoriasis Retinol Dehydrogenase 10 Scar TreatmentTyrosinase Scarring Elastin Scarring Collagen Type I Scarring CollagenType III Skin Cancer Interferon Striate Palmoplantar Keratoderma ADAM17Tanning Tyrosinase Vitiligo Melanocyte-Stimulating Hormone VitiligoTyrosinase Warts Interferon Wound Healing Elastin Wound Healing CollagenType I Wound Healing Collagen Type III Xeroderma Pigmentosum DNAPolymerase Eta

Additional illustrative targets of the present invention include thecosmetic targets listed in Table 6 of International Patent PublicationNo. WO 2013/151671, the contents of which are hereby incorporated byreference in their entirety.

Further, the present compositions and methods may be used to alter abiological and/or physiological process to, for example, reduce skinsagging, increase skin thickness, increase skin volume, reduce thenumber of wrinkles, the length of wrinkles and/or the depth of wrinkles,increase skin tightness, firmness, tone and/or elasticity, increase skinhydration and ability to retain moisture, water flow and osmoticbalance, increase the levels of skin lipids; increase the extracellularmatrix and/or adhesion and communication polypeptides; increase skinenergy production; utilization and conservation; improve oxygenutilization; improve skin cell life; improve skin cell immunity defense,heat shock stress response, antioxidant defense capacity to neutralizefree radicals, and/or toxic defense; improve the protection and recoveryfrom ultraviolet rays; improve skin cell communication and skin cellinnervations; improve cell cohesion/adhesion; improve calcium mineraland other mineral metabolism; improve cell turnover; and improve cellcircadian rhythms.

Further still, in some embodiments, the present compositions may be usedto treat a disease, disorder and/or condition and/or may alter, modifyor change the appearance of a member of the integumentary system of asubject suffering from a disease, disorder and/or condition such as, butnot limited to, acne vulgaris, acne aestivalis, acne conglobata, acnecosmetic, acne fulminans, acne keloidalis nuchae, acne mechanica, acnemedicamentosa, acne miliaris necrotica, acne necrotica, acne rosacea,actinic keratosis, acne vulgaris, acne aestivalis, acne conglobata, acnecosmetic, acne fulminans, acne keloidalis nuchae, acne mechanica, acnemedicamentosa, acne miliaris necrotica, acne necrotica, acne rosacea,acute urticaria, allergic contact dermatitis, alopecia areata,angioedema, athlete's foot, atopic dermatitis, autoeczematization, babyacne, balding, bastomycosis, blackheads, birthmarks and other skinpigmentation problems, boils, bruises, bug bites and stings, burns,cellulitis, chiggers, chloracne, cholinergic or stress uricara, chronicurticara, cold type urticara, confluent and reticulated papillomatosis,corns, cysts, dandruff, dermatitis herpetiformis, dermatographism,dyshidrotic eczema, diaper rash, dry skin, dyshidrosis, ectodermaldysplasia such as, hyprohidrotic ectodermal dysplasia and X-linkedhyprohidrotic ectodermal dysplasia, eczema, epidermaodysplasiaverruciformis, erythema nodosum, excoriated acne, exercise-inducedanaphylasis folliculitis, excess skin oil, folliculitis, freckles,frostbite, fungal nails, hair density, hair growth rate, halogen acne,hair loss, heat rash, hematoma, herpes simplex infections (e.g.non-genital), hidradenitis suppurativa, hives, hyperhidrosis,hyperpigmentation, hypohidrotic ectodermal dysplasia, hypopigmentation,impetigo, ingrown hair, heat type urticara, ingrown toenail, infantileacne or neonatal acne, itch, irritant contact dermatitis, jock itch,keloid, keratosis pilaris, lichen planus, lichen sclerosus, lupusmiliaris disseminatus faciei, melasma, moles, molluscum contagiosum,nail growth rate, nail health, neurodermatitis, nummular eczema,occupational acne, oil acne, onychomycosis, physical urticara, pilonidalcyst, pityriasis rosea, pityriasis versicolor, poison ivy, pomade acne,pseudofolliculitis barbae or acne keloidalis nuchae, psoriasis,psoriatic arthritis, pressure or delayed pressue urticara, puncturewounds such as cuts and scrapes, rash, rare or water type urticara,rhinoplasty, ringworm, rosacea, rothmund-thomson syndrome, sagging ofthe skin, scabis, scars, seborrhea, seborrheic dermatitis, shingles,skin cancer, skin tag, solar type urticara, spider bite, stretch marks,sunburn, tar acne, tropical acne, thinning of skin, thrush, tineaversicolor, transient acantholytic dermatosis, tycoon's cap or acnenecrotica miliaris, uneven skin tone, varicose veins, venous eczema,vibratory angioedema, vitiligo, warts, Weber-Christian disease,wrinkles, x-linked hypohidrotic ectodermal dysplasia, xerotic eczema,yeast infection and general signs of aging.

In some embodiments, there is provided methods of treating dry skin withthe present compositions. In some embodiments profilaggrin (a proteinwhich is converted to filaggrin) is a protein of interest (e.g. whentreating ichthyosis vulgaris).

In some embodiments, there is provided methods of treating any one ofthe various types of psoriasis (e.g. plague psoriasis, guttatepsoriasis, pustular psoriasis, inverse psoriasis, and erythrodermicpsoriasis). In various embodiments, the protein of interest is any ofthe products of the genes psoriasis susceptibility 1 through 9(PSORS1-PSORS9).

Various embodiments relate to the treatment of eczema (e.g. atopicdermatitis, nummular eczema, dyshidrotic eczema, seborrheic dermatitis,irritant contact dermatitis, allergic contact dermatitis, dyshidrosis,venous eczema, dermatitis herpetiformis, neurodermatitis,autoeczematization and xerotic eczema) and, optionally, one or more ofthe following may be targeted: filaggrin; three genetic variants,ovo-like 1 (OVOL1), actin-like 9 (ACTL9) and kinesin family member 3 A(KIF3A) have been associated with eczema; and the genes brain-derivedneurotrophic factor (BDNF) and tachykinin, precursor 1 (TAC1).

Hives, or urticaria, including, but not limited to, acute urticaria,chronic urticara and angioedema, physical urticara, pressure or delayedpressue urticara, cholinergic or stress uricara, cold type urticara,heat type urticara, solar type urticara, rare or water type urticara,vibratory angioedema, exercise-induced anaphylasis and dermatographismmay be treated with the present compositions by, for example, targetingPLCG-2.

Various embodiments relate to the treatment of rosacea, which includes,but is not limited to, erthematotelangiectatic rosacea, papulopustularrosacea, phymatous rosacea, and ocular rosacea. Optionally, cathelicidinantimicrobial peptide (CAMP) and/or kallikrein-related peptidase 5 (alsoknown as stratum corneum tryptic enzyme (SCTE)) are proteins ofinterest.

In some embodiments, there is provided methods of treating acne with thepresent compositions. For example, acne may include, but is not limitedto, acneiform eruptions, acne aestivalis, acne conglobata, acnecosmetic, acne fulminans, acne keloidalis nuchae, acne mechanica, acnemedicamentosa, acne miliaris necrotica, acne necrotica, acne rosacea,baby acne, blackheads, chloracne, excoriated acne, halogen acne,infantile acne or neonatal acne, lupus miliaris disseminatus faciei,occupational acne, oil acne, pomade acne, tar acne, tropical acne,tycoon's cap or acne necrotica miliaris, pseudofolliculitis barbae oracne keloidalis nuchae, and hidradenitis suppurativa. In theseembodiments, the protein of interest may be one or more matrixmetalloproteinases (MMP), e.g., matrix metalloproteinase-1 (MMP-1 orinterstitial collagenase), matrix metalloproteinase-9 (MMP-9), andmatrix metalloproteinase-13 (MMP-13).

In further embodiments, vitiligo is treated with the presentcompositions, e.g. wherein the NLR family, pyrin domain containing 1gene (NALP1) gene is targeted.

In some embodiments, the present compositions find use in the treatmentof hyprohidrotic ectodermal dysplasia (HED), e.g. via the ectodysplasinA gene (EDA), receptor (EDAR), and receptor associated death domain(EDARADD).

In some embodiments, the present compositions find use in the treatmentof balding, or hair thinning (e.g. male pattern baldness, orandrogenetic alopecia (AGA)) and, optionally, one or more of thefollowing may be the protein of interest: androgen receptor (AR),ectodysplasin A2 receptor (EDA2R) and lysophosphatidic acid receptor 6(P2RY5).

The present compositions also find use in methods of treating scars andstretch marks (striae), e.g. via collagen, ribosomal s6 kinase,sectrected phosphoprotein 1 (also known as osteopontin), or transforminggrowth factor beta 3.

Epidermodysplasia verruciformis (also known as Lutz-Lewandowskyepidermodysplasia), a rare autosomal recessive genetic hereditary skindisorder, may also be treated with compositions of the presentinvention, e.g. by targetted transmembrane channel-like 6 (EVER1) ortransmembrane channellike 8 (EVER2) genes.

In some embodiments, skin sagging, thinning or wrinkling may be treatedwith present composition, e.g. by targeting one or more of the proteinsof interest such as collagen, elastin, fibroblast growth factor 7, TIMPmetallopeptidase inhibitors, matrix metallopeptidases, superoxidedismutase and other extracellular matrix proteins and proteoglycans.

Further embodiments are used in tanning of the skin, such as viamelanocyte-stimulating hormone and/or pro-opiomelanocortin.

In some embodiments, the present compositions may be used for woundtreatment. In some embodiments, methods of treating wounds with thepresent compositions comprises additional steps of, for example,cleaning the wound bed to facilitate wound healing and closure,including, but not limited to: debridement, sharp debridement (surgicalremoval of dead or infected tissue from a wound), optionally includingchemical debriding agents, such as enzymes, to remove necrotic tissue;wound dressings to provide the wound with a moist, warm environment andto promote tissue repair and healing (e.g., wound dressings comprisinghydrogels (e.g., AQUASORB®; DUODERM®), hydrocolloids (e.g., AQUACEL®;COMFEEL®), foams (e.g., LYOFOAM®; SPYROSORB®), and alginates (e.g.,ALGISITE®; CURASORB®); administration of growth factors to stimulatecell division and proliferation and to promote wound healing e.g.becaplermin; and (iv) soft-tissue wound coverage, a skin graft may benecessary to obtain coverage of clean, non-healing wounds (e.g.,autologous skin grafts, cadaveric skin graft, bioengineered skinsubstitutes (e.g., APLIGRAF®; DERMAGRAFT®)).

In various embodiments, a variety of cancers are treated with thepresent compositions (e.g., colorectal cancer, gallbladder cancer, lungcancer, pancreatic cancer, and stomach cancer). In some embodiments,skin cancer is treated with the present compositions. For instance,basal cell cancer (BCC), squamous cell cancer (SCC), and melanoma. Insome embodiments, the present compositions are used adjuvant to completecircumferential peripheral and deep margin assessment, Mohs surgery,radiation (e.g. external beam radiotherapy or brachytherapy),chemotherapy (including but not limited to topical chemotherapy, e.g.with imiquimod or 5-fluorouracil), and cryotherapy. The presentcompositions also find use in the treatment of various stages ofcancers, including skin cancers (e.g. basal cell cancer (BCC), squamouscell cancer (SCC), and melanoma), such as a stage of the American JointCommittee on Cancer (AJCC) TNM system (e.g. one or more of TX, T0, Tis,T1, T1a, T1b, T2, T2A, T2B, T3, T3a, T3b, T4, T4a, T4b, NX, N0, N1, N2,N3, M0, M1a, M1b, M1c) and/or a staging system (e.g. Stage 0, Stage IA,Stage IB, Stage IIA, Stage IIB, Stage IIC, Stage IIIA, Stage IIIB, StageIIIC, Stage IV).

In various embodiments, one or more rare diseases are treated with thepresent compositions, including, by way of illustration, ErythropoieticProtoporphyria, Hailey-Hailey Disease, Epidermolysis Bullosa (EB),Xeroderma Pigmentosum, Ehlers-Danlos Syndrome, Cutis Laxa, Protein C &Protein S Deficiency, Alport Syndrome, Striate Palmoplantar Keratoderma,Lethal Acantholytic EB, Pseudoxanthoma Elasticum (PXE), IchthyosisVulgaris, Pemphigus Vulgaris, and Basal Cell Nevus Syndrome.

In certain situations, it may be desirable to replace animal-derivedcomponents with non-animal-derived and/or recombinant components, inpart because non-animal-derived and/or recombinant components can beproduced with a higher degree of consistency than animal-derivedcomponents, and in part because non-animal-derived and/or recombinantcomponents carry less risk of contamination with toxic and/or pathogenicsubstances than do animal-derived components. Certain embodiments aretherefore directed to a protein that is non-animal-derived and/orrecombinant. Other embodiments are directed to a medium, wherein some orall of the components of the medium are non-animal-derived and/orrecombinant.

Other embodiments are directed to a method for transfecting a cell invivo. In one embodiment, a cell in vivo is transfected with one or morenucleic acids, and the transfection is performed using a transfectionreagent, such as a lipid-based transfection reagent. In one embodiment,the one or more nucleic acids includes at least one RNA molecule. Inanother embodiment, the cell is transfected with one or more nucleicacids, and the one or more nucleic acids encodes at least one of: p53,TERT, a cytokine, a secreted protein, a membrane-bound protein, anenzyme, a gene-editing protein, a chromatin-modifying protein, aDNA-binding protein, a transcription factor, a histone deacetylase, apathogen-associated molecular pattern, and a tumor-associated antigen ora biologically active fragment, analogue, variant or family-memberthereof. In another embodiment, the cell is transfected repeatedly, suchas at least about 2 times during about 10 consecutive days, or at leastabout 3 times during about 7 consecutive days, or at least about 4 timesduring about 6 consecutive days.

Reprogramming can be performed by transfecting cells with one or morenucleic acids encoding one or more reprogramming factors. Examples ofreprogramming factors include, but are not limited to: Oct4 protein,Sox2 protein, Klf4 protein, c-Myc protein, l-Myc protein, TERT protein,Nanog protein, Lin28 protein, Utf1 protein, Aicda protein, miR200micro-RNA, miR302 micro-RNA, miR367 micro-RNA, miR369 micro-RNA andbiologically active fragments, analogues, variants and family-membersthereof. Certain embodiments are therefore directed to a method forreprogramming a cell in vivo. In one embodiment, the cell in vivo isreprogrammed by transfecting the cell with one or more nucleic acidsencoding one or more reprogramming factors. In one embodiment, the oneor more nucleic acids includes an RNA molecule that encodes Oct4protein. In another embodiment, the one or more nucleic acids alsoincludes one or more RNA molecules that encodes Sox2 protein, Klf4protein, and c-Myc protein. In yet another embodiment, the one or morenucleic acids also includes an RNA molecule that encodes Lin28 protein.In one embodiment, the cell is a human skin cell, and the human skincell is reprogrammed to a pluripotent stem cell. In another embodiment,the cell is a human skin cell, and the human skin cell is reprogrammedto a glucose-responsive insulin-producing cell. Examples of other cellsthat can be reprogrammed and other cells to which a cell can bereprogrammed include, but are not limited to: skin cells, pluripotentstem cells, mesenchymal stem cells, 8-cells, retinal pigmentedepithelial cells, hematopoietic cells, cardiac cells, airway epithelialcells, neural stem cells, neurons, glial cells, bone cells, blood cells,and dental pulp stem cells. In one embodiment, the cell is contactedwith a medium that supports the reprogrammed cell. In one embodiment,the medium also supports the cell.

Importantly, infecting skin cells with viruses encoding Oct4, Sox2,Klf4, and c-Myc, combined with culturing the cells in a medium thatsupports the growth of cardiomyocytes, has been reported to causereprogramming of the skin cells to cardiomyocytes, without firstreprogramming the skin cells to pluripotent stem cells (See Efs et alNat Cell Biol. 2011; 13:215-22, the contents of which are herebyincorporated by reference). In certain situations, direct reprogramming(reprogramming one somatic cell to another somatic cell without firstreprogramming the somatic cell to a pluripotent stem cell, also known as“transdifferentiation”) may be desirable, in part because culturingpluripotent stem cells can be time-consuming and expensive, theadditional handling involved in establishing and characterizing a stablepluripotent stem cell line can carry an increased risk of contamination,and the additional time in culture associated with first producingpluripotent stem cells can carry an increased risk of genomicinstability and the acquisition of mutations, including point mutations,copy-number variations, and karyotypic abnormalities. Certainembodiments are therefore directed to a method for reprogramming asomatic cell in vivo, wherein the cell is reprogrammed to a somaticcell, and wherein a characterized pluripotent stem-cell line is notproduced.

It has been further discovered that, in certain situations, fewer totaltransfections may be required to reprogram a cell according to themethods of the present invention than according to other methods.Certain embodiments are therefore directed to a method for reprogramminga cell in vivo, wherein between about 1 and about 12 transfections areperformed during about 20 consecutive days, or between about 4 and about10 transfections are performed during about 15 consecutive days, orbetween about 4 and about 8 transfections are performed during about 10consecutive days. It is recognized that when a cell is contacted with amedium containing nucleic acid molecules, the cell may likely come intocontact with and/or internalize more than one nucleic acid moleculeeither simultaneously or at different times. A cell can therefore becontacted with a nucleic acid more than once, e.g. repeatedly, even whena cell is contacted only once with a medium containing nucleic acids.

Of note, nucleic acids can contain one or more non-canonical, or“modified”, residues (e.g. a residue other than adenine, guanine,thymine, uracil, and cytosine or the standard nucleoside, nucleotide,deoxynucleoside or deoxynucleotide derivatives thereof). Of particularnote, pseudouridine-5-triphosphate can be substituted foruridine-5-triphosphate in an in vitro-transcription reaction to yieldsynthetic RNA, wherein up to 100% of the uridine residues of thesynthetic RNA may be replaced with pseudouridine residues. Invitro-transcription can yield RNA with residual immunogenicity, evenwhen pseudouridine and 5-methylcytidine are completely substituted foruridine and cytidine, respectively (See, e.g., Angel. ReprogrammingHuman Somatic Cells to Pluripotency Using RNA [Doctoral Thesis].Cambridge, Mass.: MIT; 2011, the contents of which are herebyincorporated by reference). For this reason, it is common to add animmunosuppressant to the transfection medium when transfecting cellswith RNA. In certain situations, adding an immunosuppressant to thetransfection medium may not be desirable, in part because therecombinant immunosuppressant most commonly used for this purpose, B18R,can be expensive and difficult to manufacture. It has now beendiscovered that cells in vivo can be transfected and/or reprogrammedaccording to the methods of the present invention, without using B18R orany other immunosuppressant. It has been further discovered thatreprogramming cells in vivo according to the methods of the presentinvention without using immunosuppressants can be rapid, efficient, andreliable. Certain embodiments are therefore directed to a method fortransfecting a cell in vivo, wherein the transfection medium does notcontain an immunosuppressant. Other embodiments are directed to a methodfor reprogramming a cell in vivo, wherein the transfection medium doesnot contain an immunosuppressant. In certain situations, for examplewhen using a high cell density, it may be beneficial to add animmunosuppressant to the transfection medium. Certain embodiments aretherefore directed to a method for transfecting a cell in vivo, whereinthe transfection medium contains an immunosuppressant. Other embodimentsare directed to a method for reprogramming a cell in vivo, wherein thetransfection medium contains an immunosuppressant. In one embodiment,the immunosuppressant is B18R or a biologically active fragment,analogue, variant or family-member thereof or dexamethasone or aderivative thereof. In one embodiment, the transfection medium does notcontain an immunosuppressant, and the nucleic-acid dose is chosen toprevent excessive toxicity. In another embodiment, the nucleic-acid doseis less than about 1 mg/cm² of tissue or less than about 1 mg/100,000cells or less than about 10 mg/kg.

Reprogrammed cells produced according to certain embodiments of thepresent invention are suitable for therapeutic and/or cosmeticapplications as they do not contain exogenous DNA sequences, and theyare not exposed to animal-derived or human-derived products, which maybe undefined, and which may contain toxic and/or pathogeniccontaminants. Furthermore, the high speed, efficiency, and reliabilityof certain embodiments of the present invention may reduce the risk ofacquisition and accumulation of mutations and other chromosomalabnormalities. Certain embodiments of the present invention can thus beused to generate cells that have a safety profile adequate for use intherapeutic and/or cosmetic applications. For example, reprogrammingcells using RNA and the medium of the present invention, wherein themedium does not contain animal or human-derived components, can yieldcells that have not been exposed to allogeneic material. Certainembodiments are therefore directed to a reprogrammed cell that has adesirable safety profile. In one embodiment, the reprogrammed cell has anormal karyotype. In another embodiment, the reprogrammed cell has fewerthan about 5 copy-number variations (CNVs) relative to the patientgenome, such as fewer than about 3 copy-number variations relative tothe patient genome, or no copy-number variations relative to the patientgenome. In yet another embodiment, the reprogrammed cell has a normalkaryotype and fewer than about 100 single nucleotide variants in codingregions relative to the patient genome, or fewer than about 50 singlenucleotide variants in coding regions relative to the patient genome, orfewer than about 10 single nucleotide variants in coding regionsrelative to the patient genome.

Endotoxins and nucleases can co-purify and/or become associated withother proteins, such as serum albumin. Recombinant proteins, inparticular, can often have high levels of associated endotoxins andnucleases, due in part to the lysis of cells that can take place duringtheir production. Endotoxins and nucleases can be reduced, removed,replaced or otherwise inactivated by many of the methods of the presentinvention, including, for example, by acetylation, by addition of astabilizer such as sodium octanoate, followed by heat treatment, by theaddition of nuclease inhibitors to the albumin solution and/or medium,by crystallization, by contacting with one or more ion-exchange resins,by contacting with charcoal, by preparative electrophoresis or byaffinity chromatography. It has now been discovered that partially orcompletely reducing, removing, replacing or otherwise inactivatingendotoxins and/or nucleases from a medium and/or from one or morecomponents of a medium can increase the efficiency with which cells canbe transfected and reprogrammed. Certain embodiments are thereforedirected to a method for transfecting a cell in vivo with one or morenucleic acids, wherein the transfection medium is treated to partiallyor completely reduce, remove, replace or otherwise inactivate one ormore endotoxins and/or nucleases. Other embodiments are directed to amedium that causes minimal degradation of nucleic acids. In oneembodiment, the medium contains less than about 1 EU/mL, or less thanabout 0.1 EU/mL, or less than about 0.01 EU/mL.

In certain situations, protein-based lipid carriers such as serumalbumin can be replaced with non-protein-based lipid carriers such asmethyl-beta-cyclodextrin. The medium of the present invention can alsobe used without a lipid carrier, for example, when transfection isperformed using a method that may not require or may not benefit fromthe presence of a lipid carrier, for example, using one or morelipid-based transfection reagents, polymer-based transfection reagentsor peptide-based transfection reagents or using electroporation. Manyprotein-associated molecules, such as metals, can be highly toxic tocells in vivo. This toxicity can cause decreased viability, as well asthe acquisition of mutations. Certain embodiments thus have theadditional benefit of producing cells that are free from toxicmolecules.

The associated-molecule component of a protein can be measured bysuspending the protein in solution and measuring the conductivity of thesolution. Certain embodiments are therefore directed to a medium thatcontains a protein, wherein about a 10% solution of the protein in waterhas a conductivity of less than about 500 μmho/cm. In one embodiment,the solution has a conductivity of less than about 50 μmho/cm. Inanother embodiment, less than about 0.65% of the dry weight of theprotein comprises lipids and/or less than about 0.35% of the dry weightof the protein comprises free fatty acids.

The amount of nucleic acid delivered to cells in vivo can be increasedto increase the desired effect of the nucleic acid. However, increasingthe amount of nucleic acid delivered to cells in vivo beyond a certainpoint can cause a decrease in the viability of the cells, due in part totoxicity of the transfection reagent. It has now been discovered thatwhen a nucleic acid is delivered to a population of cells in vivo in afixed volume (for example, cells in a region of tissue), the amount ofnucleic acid delivered to each cell can depend on the total amount ofnucleic acid delivered to the population of cells and to the density ofthe cells, with a higher cell density resulting in less nucleic acidbeing delivered to each cell. In certain embodiments, a cell in vivo istransfected with one or more nucleic acids more than once. Under certainconditions, for example when the cells are proliferating, the celldensity may change from one transfection to the next. Certainembodiments are therefore directed to a method for transfecting a cellin vivo with a nucleic acid, wherein the cell is transfected more thanonce, and wherein the amount of nucleic acid delivered to the cell isdifferent for two of the transfections. In one embodiment, the cellproliferates between two of the transfections, and the amount of nucleicacid delivered to the cell is greater for the second of the twotransfections than for the first of the two transfections. In anotherembodiment, the cell is transfected more than twice, and the amount ofnucleic acid delivered to the cell is greater for the second of threetransfections than for the first of the same three transfections, andthe amount of nucleic acid delivered to the cells is greater for thethird of the same three transfections than for the second of the samethree transfections. In yet another embodiment, the cell is transfectedmore than once, and the maximum amount of nucleic acid delivered to thecell during each transfection is sufficiently low to yield at leastabout 80% viability for at least two consecutive transfections.

It has now been discovered that modulating the amount of nucleic aciddelivered to a population of proliferating cells in vivo in a series oftransfections can result in both an increased effect of the nucleic acidand increased viability of the cells. It has been further discoveredthat, in certain situations, when cells in vivo are contacted with oneor more nucleic acids encoding one or more reprogramming factors in aseries of transfections, the efficiency of reprogramming can beincreased when the amount of nucleic acid delivered in latertransfections is greater than the amount of nucleic acid delivered inearlier transfections, for at least part of the series of transfections.Certain embodiments are therefore directed to a method for reprogramminga cell in vivo, wherein one or more nucleic acids is repeatedlydelivered to the cell in a series of transfections, and the amount ofthe nucleic acid delivered to the cell is greater for at least one latertransfection than for at least one earlier transfection. In oneembodiment, the cell is transfected between about 2 and about 10 times,or between about 3 and about 8 times, or between about 4 and about 6times. In another embodiment, the one or more nucleic acids includes atleast one RNA molecule, the cell is transfected between about 2 andabout 10 times, and the amount of nucleic acid delivered to the cell ineach transfection is the same as or greater than the amount of nucleicacid delivered to the cell in the most recent previous transfection. Inyet another embodiment, the amount of nucleic acid delivered to the cellin the first transfection is between about 20 ng/cm² and about 250ng/cm², or between 100 ng/cm² and 600 ng/cm². In yet another embodiment,the cell is transfected about 5 times at intervals of between about 12and about 48 hours, and the amount of nucleic acid delivered to the cellis about 25 ng/cm² for the first transfection, about 50 ng/cm² for thesecond transfection, about 100 ng/cm² for the third transfection, about200 ng/cm² for the fourth transfection, and about 400 ng/cm² for thefifth transfection. In yet another embodiment, the cell is furthertransfected at least once after the fifth transfection, and the amountof nucleic acid delivered to the cell is about 400 ng/cm².

Certain embodiments are directed to a method for transfecting a cell invivo with a nucleic acid, wherein the amount of nucleic acid isdetermined by measuring the cell density, and choosing the amount ofnucleic acid to transfect based on the measurement of cell density. Inone embodiment, the cell density is measured by optical means. Inanother embodiment, the cell is transfected repeatedly, the cell densityincreases between two transfections, and the amount of nucleic acidtransfected is greater for the second of the two transfections than forthe first of the two transfections.

It has now been discovered that, in certain situations, the in vivotransfection efficiency and viability of cells contacted with the mediumof the present invention can be improved by conditioning the medium.Certain embodiments are therefore directed to a method for conditioninga medium. Other embodiments are directed to a medium that isconditioned. In one embodiment, the feeders are fibroblasts, and themedium is conditioned for approximately 24 hours. Other embodiments aredirected to a method for transfecting a cell in vivo, wherein thetransfection medium is conditioned. Other embodiments are directed to amethod for reprogramming and/or gene-editing a cell in vivo, wherein themedium is conditioned. In one embodiment, the feeders are mitoticallyinactivated, for example, by exposure to a chemical such as mitomycin-Cor by exposure to gamma radiation. In certain embodiments, it may bebeneficial to use only autologous materials, in part to, for example andnot wishing to be bound by theory, avoid the risk of diseasetransmission from the feeders to the cell or the patient. Certainembodiments are therefore directed to a method for transfecting a cellin vivo, wherein the transfection medium is conditioned, and wherein thefeeders are derived from the same individual as the cell beingtransfected. Other embodiments are directed to a method forreprogramming and/or gene-editing a cell in vivo, wherein the medium isconditioned, and wherein the feeders are derived from the sameindividual as the cell being reprogrammed and/or gene-edited.

Several molecules can be added to media by conditioning. Certainembodiments are therefore directed to a medium that is supplemented withone or more molecules that are present in a conditioned medium. In oneembodiment, the medium is supplemented with Wnt1, Wnt2, Wnt3, Wnt3a or abiologically active fragment, analogue, variant, agonist, orfamily-member thereof. In another embodiment, the medium is supplementedwith TGF-β or a biologically active fragment, analogue, variant,agonist, or family-member thereof. In yet another embodiment, a cell invivo is reprogrammed according to the method of the present invention,wherein the medium is not supplemented with TGF-β for between about 1and about 5 days, and is then supplemented with TGF-β for at least about2 days. In yet another embodiment, the medium is supplemented with IL-6,IL-6R or a biologically active fragment, analogue, variant, agonist, orfamily-member thereof. In yet another embodiment, the medium issupplemented with a sphingolipid or a fatty acid. In still anotherembodiment, the sphingolipid is lysophosphatidic acid,lysosphingomyelin, sphingosine-1-phosphate or a biologically activeanalogue, variant or derivative thereof.

In addition to mitotically inactivating cells, under certain conditions,irradiation can change the gene expression of cells, causing cells toproduce less of certain proteins and more of certain other proteins thatnon-irradiated cells, for example, members of the Wnt family ofproteins. In addition, certain members of the Wnt family of proteins canpromote the growth and transformation of cells. It has now beendiscovered that, in certain situations, the efficiency of reprogrammingcan be greatly increased by contacting a cell in vivo with a medium thatis conditioned using irradiated feeders instead of mitomycin-c-treatedfeeders. It has been further discovered that the increase inreprogramming efficiency observed when using irradiated feeders iscaused in part by Wnt proteins that are secreted by the feeders. Certainembodiments are therefore directed to a method for reprogramming a cellin vivo, wherein the cell is contacted with Wnt1, Wnt2, Wnt3, Wnt3a or abiologically active fragment, analogue, variant, family-member oragonist thereof, including agonists of downstream targets of Wntproteins, and/or agents that mimic one or more of the biological effectsof Wnt proteins, for example,2-amino-4-[3,4-(methylenedioxy)benzylamino]-6-(3-methoxyphenyl)pyrimidine.

Because of the low efficiency of many DNA-based reprogramming methods,these methods may be difficult or impossible to use with cells derivedfrom patient samples, which may contain only a small number of cells. Incontrast, the high efficiency of certain embodiments of the presentinvention can allow reliable reprogramming of a small number of cells,including single cells. Certain embodiments are directed to a method forreprogramming a small number of cells. Other embodiments are directed toa method for reprogramming a single cell. In one embodiment, the cell iscontacted with one or more enzymes. In another embodiment, the enzyme iscollagenase. In yet another embodiment, the collagenase isanimal-component free. In one embodiment, the collagenase is present ata concentration of between about 0.1 mg/mL and about 10 mg/mL, orbetween about 0.5 mg/mL and about 5 mg/mL. In another embodiment, thecell is a blood cell. In yet another embodiment, the cell is contactedwith a medium containing one or more proteins that is derived from thepatient's blood. In still another embodiment, the cell is contacted witha medium comprising: DMEM/F12+2 mM L-alanyl-L-glutamine+between about 5%and about 25% patient-derived serum, or between about 10% and about 20%patient-derived serum, or about 20% patient-derived serum.

It has now been discovered that, in certain situations, transfectingcells in vivo with a mixture of RNA encoding Oct4, Sox2, Klf4, and c-Mycusing the medium of the present invention can cause the rate ofproliferation of the cells to increase. When the amount of RNA deliveredto the cells is too low to ensure that all of the cells are transfected,only a fraction of the cells may show an increased proliferation rate.In certain situations, such as when generating a personalizedtherapeutic, increasing the proliferation rate of cells may bedesirable, in part because doing so can reduce the time necessary togenerate the therapeutic, and therefore can reduce the cost of thetherapeutic. Certain embodiments are therefore directed to a method fortransfecting a cell in vivo with a mixture of RNA encoding Oct4, Sox2,Klf4, and c-Myc. In one embodiment, the cell exhibits an increasedproliferation rate. In another embodiment, the cell is reprogrammed.

Many diseases are associated with one or more mutations. Mutations canbe corrected by contacting a cell with a nucleic acid that encodes aprotein that, either alone or in combination with other molecules,corrects the mutation (an example of gene-editing). Examples of suchproteins include: zinc finger nucleases and TALENs. Certain embodimentsare therefore directed to a method for transfecting a cell in vivo witha nucleic acid, wherein the nucleic acid encodes a protein that, eitheralone or in combination with other molecules, creates a single-strand ordouble-strand break in a DNA molecule. In a one embodiment, the proteinis a zinc finger nuclease or a TALEN. In another embodiment, the nucleicacid is an RNA molecule. In yet another embodiment, the single-strand ordouble-strand break is within about 5,000,000 bases of the transcriptionstart site of a gene selected from the group: CCR5, CXCR4, GAD1, GAD2,CFTR, HBA1, HBA2, HBB, HBD, FANCA, XPA, XPB, XPC, ERCC2, POLH, HTT, DMD,SOD1, APOE, PRNP, BRCA1, and BRCA2 or an analogue, variant orfamily-member thereof. In yet another embodiment, the cell istransfected with a nucleic acid that acts as a repair template by eithercausing the insertion of a DNA sequence in the region of thesingle-strand or double-strand break or by causing the DNA sequence inthe region of the single-strand or double-strand break to otherwisechange. In yet another embodiment, the cell is reprogrammed, andsubsequently, the cell is gene-edited. In yet another embodiment, thecell is gene-edited, and subsequently, the cell is reprogrammed. In yetanother embodiment, the gene-editing and reprogramming are performedwithin about 7 days of each other. In yet another embodiment, thegene-editing and reprogramming occur simultaneously or on the same day.In yet another embodiment, the cell is a skin cell, the skin cell isgene-edited to disrupt the CCR5 gene, the skin cell is reprogrammed to ahematopoietic stem cell, thus producing a therapeutic for HIV/AIDS, andthe therapeutic is used to treat a patient with HIV/AIDS. In yet anotherembodiment, the skin cell is derived from the same patient whom thetherapeutic is used to treat.

Genes that can be edited according to the methods of the presentinvention to produce therapeutics of the present invention include genesthat can be edited to restore normal function, as well as genes that canbe edited to reduce or eliminate function. Such genes include, but arenot limited to beta globin (HBB), mutations in which can cause sicklecell disease (SCD) and β-thalassemia, breast cancer 1, early onset(BRCA1) and breast cancer 2, early onset (BRCA2), mutations in which canincrease susceptibility to breast cancer, C—C chemokine receptor type 5(CCR5) and C—X—C chemokine receptor type 4 (CXCR4), mutations in whichcan confer resistance to HIV infection, cystic fibrosis transmembraneconductance regulator (CFTR), mutations in which can cause cysticfibrosis, dystrophin (DMD), mutations in which can cause musculardystrophy, including Duchenne muscular dystrophy and Becker's musculardystrophy, glutamate decarboxylase 1 and glutamate decarboxylase 2(GAD1, GAD2), mutations in which can prevent autoimmune destruction of3-cells, hemoglobin alpha 1, hemoglobin alpha 2, and hemoglobin delta(HBA1, HBA2, and HBD), mutations in which can cause thalassemia,Huntington (HTT), mutations in which can cause Huntington's disease,superoxide dismutase 1 (SOD1), mutations in which can cause amyotrophiclateral sclerosis (ALS), XPA, XPB, XPC, XPD (ERCC6) and polymerase (DNAdirected), eta (POLH), mutations in which can cause xerodermapigmentosum, leucine-rich repeat kinase 2 (LRRK2), mutations in whichcan cause Parkinson's disease, and Fanconi anemia, complementationgroups A, B, C, D1, D2, E, F, G, I, J, L, M, N, P (FANCA, FANCB, FANCC,FANCD1, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCJ, FANCL, FANCM, FANCN,FANCP), and RAD51 homolog C (S. cerevisiae) (RAD51C), mutations in whichcan cause Fanconi anemia.

Certain embodiments are directed to a therapeutic comprising a nucleicacid. In one embodiment, the nucleic acid encodes one or moregene-editing proteins. Other embodiments are directed to a therapeuticcomprising one or more cells that are transfected, reprogrammed, and/orgene-edited in vivo according to the methods of the present invention.In one embodiment, a cell is transfected, reprogrammed, and/orgene-edited, and the transfected, reprogrammed, and/or gene-edited cellis introduced into a patient. In another embodiment, the cell isharvested from the same patient into whom the transfected, reprogrammedand/or gene-edited cell is introduced. Examples of diseases that can betreated with therapeutics of the present invention include, but are notlimited to Alzheimer's disease, spinal cord injury, amyotrophic lateralsclerosis, cystic fibrosis, heart disease, including ischemic anddilated cardiomyopathy, macular degeneration, Parkinson's disease,Huntington's disease, diabetes, sickle-cell anemia, thalassemia, Fanconianemia, xeroderma pigmentosum, muscular dystrophy, severe combinedimmunodeficiency, hereditary sensory neuropathy, cancer, and HIV/AIDS.In certain embodiments, the therapeutic comprises a cosmetic. In oneembodiment, a cell is harvested from a patient, the cell is reprogrammedand expanded to a large number of adipose cells to produce a cosmetic,and the cosmetic is introduced into the patient. In still anotherembodiment, the cosmetic is used for tissue reconstruction.

While detailed examples are provided herein for the production ofspecific types of cells and for the production of therapeuticscomprising specific types of cells, it is recognized that the methods ofthe present invention can be used to produce many other types of cells,and to produce therapeutics comprising one or more of many other typesof cells, for example, by reprogramming a cell according to the methodsof the present invention, and culturing the cell under conditions thatmimic one or more aspects of development by providing conditions thatresemble the conditions present in the cellular microenvironment duringdevelopment.

Certain embodiments are directed to a library of cells with a variety ofhuman leukocyte antigen (HLA) types (“HLA-matched libraries”). AnHLA-matched library may be beneficial in part because it can provide forthe rapid production and/or distribution of therapeutics without thepatient having to wait for a therapeutic to be produced from thepatient's cells. Such a library may be particularly beneficial for theproduction of cosmetics and for the treatment of heart disease anddiseases of the blood and/or immune system for which patients maybenefit from the immediate availability of a therapeutic or cosmetic.

Certain non-canonical nucleotides, when incorporated into synthetic RNAmolecules, can reduce the toxicity of the synthetic RNA molecules, inpart by interfering with binding of proteins that detect exogenousnucleic acids, for example, protein kinase R, Rig-1 and theoligoadenylate synthetase family of proteins. Non-canonical nucleotidesthat have been reported to reduce the toxicity of synthetic RNAmolecules when incorporated therein include: pseudouridine,5-methyluridine, 2-thiouridine, 5-methylcytidine, N6-methyladenosine,and certain combinations thereof. However, the chemical characteristicsof non-canonical nucleotides that can enable them to lower the in vivotoxicity of synthetic RNA molecules have, until this point, remainedunknown. Furthermore, incorporation of large amounts of mostnon-canonical nucleotides, for example, 5-methyluridine, 2-thiouridine,5-methylcytidine, and N6-methyladenosine, can reduce the efficiency withwhich synthetic RNA molecules can be translated into protein, limitingthe utility of synthetic RNA molecules containing these nucleotides inapplications that require protein expression. In addition, whilepseudouridine can be completely substituted for uridine in synthetic RNAmolecules without reducing the efficiency with which the synthetic RNAmolecules can be translated into protein, in certain situations, forexample, when performing frequent, repeated transfections, synthetic RNAmolecules containing only adenosine, guanosine, cytidine, andpseudouridine can exhibit excessive toxicity.

It has now been discovered that synthetic RNA molecules containing oneor more non-canonical nucleotides that include one or more substitutionsat the 2C and/or 4C and/or 5C positions in the case of a pyrimidine orthe 6C and/or 7N and/or 8C positions in the case of a purine can be lesstoxic than synthetic RNA molecules containing only canonicalnucleotides, due in part to the ability of substitutions at thesepositions to interfere with recognition of synthetic RNA molecules byproteins that detect exogenous nucleic acids, and furthermore, thatsubstitutions at these positions can have minimal impact on theefficiency with which the synthetic RNA molecules can be translated intoprotein, due in part to the lack of interference of substitutions atthese positions with base-pairing and base-stacking interactions.

Examples of non-canonical nucleotides that include one or moresubstitutions at the 2C and/or 4C and/or 5C positions in the case of apyrimidine or the 6C and/or 7N and/or 8C positions in the case of apurine include, but are not limited to: 2-thiouridine, 5-azauridine,pseudouridine, 4-thiouridine, 5-methyluridine, 5-aminouridine,5-hydroxyuridine, 5-methyl-5-azauridine, 5-amino-5-azauridine,5-hydroxy-5-azauridine, 5-methylpseudouridine, 5-aminopseudouridine,5-hydroxypseudouridine, 4-thio-5-azauridine, 4-thiopseudouridine,4-thio-5-methyluridine, 4-thio-5-aminouridine, 4-thio-5-hydroxyuridine,4-thio-5-methyl-5-azauridine, 4-thio-5-amino-5-azauridine,4-thio-5-hydroxy-5-azauridine, 4-thio-5-methylpseudouridine,4-thio-5-aminopseudouridine, 4-thio-5-hydroxypseudouridine,2-thiocytidine, 5-azacytidine, pseudoisocytidine, N4-methylcytidine,N4-aminocytidine, N4-hydroxycytidine, 5-methylcytidine, 5-aminocytidine,5-hydroxycytidine, 5-methyl-5-azacytidine, 5-amino-5-azacytidine,5-hydroxy-5-azacytidine, 5-methylpseudoisocytidine,5-aminopseudoisocytidine, 5-hydroxypseudoisocytidine,N4-methyl-5-azacytidine, N4-methylpseudoisocytidine,2-thio-5-azacytidine, 2-thiopseudoisocytidine, 2-thio-N4-methylcytidine,2-thio-N4-aminocytidine, 2-thio-N4-hydroxycytidine,2-thio-5-methylcytidine, 2-thio-5-aminocytidine,2-thio-5-hydroxycytidine, 2-thio-5-methyl-5-azacytidine,2-thio-5-amino-5-azacytidine, 2-thio-5-hydroxy-5-azacytidine,2-thio-5-methylpseudoisocytidine, 2-thio-5-aminopseudoisocytidine,2-thio-5-hydroxypseudoisocytidine, 2-thio-N4-methyl-5-azacytidine,2-thio-N4-methylpseudoisocytidine, N4-methyl-5-methylcytidine,N4-methyl-5-aminocytidine, N4-methyl-5-hydroxycytidine,N4-methyl-5-methyl-5-azacytidine, N4-methyl-5-amino-5-azacytidine,N4-methyl-5-hydroxy-5-azacytidine, N4-methyl-5-methylpseudoisocytidine,N4-methyl-5-aminopseudoisocytidine,N4-methyl-5-hydroxypseudoisocytidine, N4-amino-5-azacytidine,N4-aminopseudoisocytidine, N4-amino-5-methylcytidine,N4-amino-5-aminocytidine, N4-amino-5-hydroxycytidine,N4-amino-5-methyl-5-azacytidine, N4-amino-5-amino-5-azacytidine,N4-amino-5-hydroxy-5-azacytidine, N4-amino-5-methylpseudoisocytidine,N4-amino-5-aminopseudoisocytidine, N4-amino-5-hydroxypseudoisocytidine,N4-hydroxy-5-azacytidine, N4-hydroxypseudoisocytidine,N4-hydroxy-5-methylcytidine, N4-hydroxy-5-aminocytidine,N4-hydroxy-5-hydroxycytidine, N4-hydroxy-5-methyl-5-azacytidine,N4-hydroxy-5-amino-5-azacytidine, N4-hydroxy-5-hydroxy-5-azacytidine,N4-hydroxy-5-methylpseudoisocytidine,N4-hydroxy-5-aminopseudoisocytidine,N4-hydroxy-5-hydroxypseudoisocytidine,2-thio-N4-methyl-5-methylcytidine, 2-thio-N4-methyl-5-aminocytidine,2-thio-N4-methyl-5-hydroxycytidine,2-thio-N4-methyl-5-methyl-5-azacytidine,2-thio-N4-methyl-5-amino-5-azacytidine,2-thio-N4-methyl-5-hydroxy-5-azacytidine,2-thio-N4-methyl-5-methylpseudoisocytidine,2-thio-N4-methyl-5-aminopseudoisocytidine,2-thio-N4-methyl-5-hydroxypseudoisocytidine,2-thio-N4-amino-5-azacytidine, 2-thio-N4-aminopseudoisocytidine,2-thio-N4-amino-5-methylcytidine, 2-thio-N4-amino-5-aminocytidine,2-thio-N4-amino-5-hydroxycytidine,2-thio-N4-amino-5-methyl-5-azacytidine,2-thio-N4-amino-5-amino-5-azacytidine,2-thio-N4-amino-5-hydroxy-5-azacytidine,2-thio-N4-amino-5-methylpseudoisocytidine,2-thio-N4-amino-5-aminopseudoisocytidine,2-thio-N4-amino-5-hydroxypseudoisocytidine,2-thio-N4-hydroxy-5-azacytidine, 2-thio-N4-hydroxypseudoisocytidine,2-thio-N4-hydroxy-5-methylcytidine, N4-hydroxy-5-aminocytidine,2-thio-N4-hydroxy-5-hydroxycytidine,2-thio-N4-hydroxy-5-methyl-5-azacytidine,2-thio-N4-hydroxy-5-amino-5-azacytidine,2-thio-N4-hydroxy-5-hydroxy-5-azacytidine,2-thio-N4-hydroxy-5-methylpseudoisocytidine,2-thio-N4-hydroxy-5-aminopseudoisocytidine,2-thio-N4-hydroxy-5-hydroxypseudoisocytidine, N6-methyladenosine,N6-aminoadenosine, N6-hydroxyadenosine, 7-deazaadenosine,8-azaadenosine, N6-methyl-7-deazaadenosine, N6-methyl-8-azaadenosine,7-deaza-8-azaadenosine, N6-methyl-7-deaza-8-azaadenosine,N6-amino-7-deazaadenosine, N6-amino-8-azaadenosine,N6-amino-7-deaza-8-azaadenosine, N6-hydroxyadenosine,N6-hydroxy-7-deazaadenosine, N6-hydroxy-8-azaadenosine,N6-hydroxy-7-deaza-8-azaadenosine, 6-thioguanosine, 7-deazaguanosine,8-azaguanosine, 6-thio-7-deazaguanosine, 6-thio-8-azaguanosine,7-deaza-8-azaguanosine, and 6-thio-7-deaza-8-azaguanosine. Note thatalternative naming schemes exist for certain non-canonical nucleotides.For example, in certain situations, 5-methylpseudouridine can bereferred to as “3-methylpseudouridine” or “N3-methylpseudouridine” or“1-methylpseudouridine” or “N1-methylpseudouridine”.

Nucleotides that contain the prefix “amino” can refer to any nucleotidethat contains a nitrogen atom bound to the atom at the stated positionof the nucleotide, for example, 5-aminocytidine can refer to5-aminocytidine, 5-methylaminocytidine, and 5-nitrocytidine. Similarly,nucleotides that contain the prefix “methyl” can refer to any nucleotidethat contains a carbon atom bound to the atom at the stated position ofthe nucleotide, for example, 5-methylcytidine can refer to5-methylcytidine, 5-ethylcytidine, and 5-hydroxymethylcytidine,nucleotides that contain the prefix “thio” can refer to any nucleotidethat contains a sulfur atom bound to the atom at the given position ofthe nucleotide, and nucleotides that contain the prefix “hydroxy” canrefer to any nucleotide that contains an oxygen atom bound to the atomat the given position of the nucleotide, for example, 5-hydroxyuridinecan refer to 5-hydroxyuridine and uridine with a methyl group bound toan oxygen atom, wherein the oxygen atom is bound to the atom at the 5Cposition of the uridine.

Certain embodiments are therefore directed to a synthetic RNA molecule,wherein the synthetic RNA molecule contains one or more nucleotides thatincludes one or more substitutions at the 2C and/or 4C and/or 5Cpositions in the case of a pyrimidine or the 6C and/or 7N and/or 8Cpositions in the case of a purine. Other embodiments are directed to atherapeutic, wherein the therapeutic contains one or more synthetic RNAmolecules, and wherein the one or more synthetic RNA molecules containsone or more nucleotides that includes one or more substitutions at the2C and/or 4C and/or 5C positions in the case of a pyrimidine or the 6Cand/or 7N and/or 8C positions in the case of a purine. In oneembodiment, the therapeutic comprises a transfection reagent. In anotherembodiment, the transfection reagent comprises a cationic lipid,liposome or micelle. In still another embodiment, the liposome ormicelle comprises folate and the therapeutic composition has anti-canceractivity. In another embodiment, the one or more nucleotides includes atleast one of pseudouridine, 2-thiouridine, 4-thiouridine, 5-azauridine,5-hydroxyuridine, 5-methyluridine, 5-aminouridine, 2-thiopseudouridine,4-thiopseudouridine, 5-hydroxypseudouridine, 5-methylpseudouridine,5-aminopseudouridine, pseudoisocytidine, N4-methylcytidine,2-thiocytidine, 5-azacytidine, 5-hydroxycytidine, 5-aminocytidine,5-methylcytidine, N4-methylpseudoisocytidine, 2-thiopseudoisocytidine,5-hydroxypseudoisocytidine, 5-aminopseudoisocytidine,5-methylpseudoisocytidine, 7-deazaadenosine, 7-deazaguanosine,6-thioguanosine, and 6-thio-7-deazaguanosine. In another embodiment, theone or more nucleotides includes at least one of pseudouridine,2-thiouridine, 4-thiouridine, 5-azauridine, 5-hydroxyuridine,5-methyluridine, 5-aminouridine, 2-thiopseudouridine,4-thiopseudouridine, 5-hydroxypseudouridine, 5-methylpseudouridine, and5-aminopseudouridine and at least one of pseudoisocytidine,N4-methylcytidine, 2-thiocytidine, 5-azacytidine, 5-hydroxycytidine,5-aminocytidine, 5-methylcytidine, N4-methylpseudoisocytidine,2-thiopseudoisocytidine, 5-hydroxypseudoisocytidine,5-aminopseudoisocytidine, and 5-methylpseudoisocytidine. In stillanother embodiment, the one or more nucleotides include at least one ofpseudouridine, 2-thiouridine, 4-thiouridine, 5-azauridine,5-hydroxyuridine, 5-methyluridine, 5-aminouridine, 2-thiopseudouridine,4-thiopseudouridine, 5-hydroxypseudouridine, and 5-methylpseudouridine,5-aminopseudouridine and at least one of pseudoisocytidine,N4-methylcytidine, 2-thiocytidine, 5-azacytidine, 5-hydroxycytidine,5-aminocytidine, 5-methylcytidine, N4-methylpseudoisocytidine,2-thiopseudoisocytidine, 5-hydroxypseudoisocytidine,5-aminopseudoisocytidine, and 5-methylpseudoisocytidine and at least oneof 7-deazaguanosine, 6-thioguanosine, and 6-thio-7-deazaguanosine. Inyet another embodiment, the one or more nucleotides includes:5-methylcytidine and 7-deazaguanosine. In another embodiment, the one ormore nucleotides also includes pseudouridine or 4-thiouridine or5-methyluridine or 5-aminouridine or 4-thiopseudouridine or5-methylpseudouridine or 5-aminopseudouridine. In a still anotherembodiment, the one or more nucleotides also includes 7-deazaadenosine.In another embodiment, the one or more nucleotides includes:pseudoisocytidine and 7-deazaguanosine and 4-thiouridine. In yet anotherembodiment, the one or more nucleotides includes: pseudoisocytidine or7-deazaguanosine and pseudouridine. In still another embodiment, the oneor more nucleotides includes: 5-methyluridine and 5-methylcytidine and7-deazaguanosine. In a further embodiment, the one or more nucleotidesincludes: pseudouridine or 5-methylpseudouridine and 5-methylcytidineand 7-deazaguanosine. In another embodiment, the one or more nucleotidesincludes: pseudoisocytidine and 7-deazaguanosine and pseudouridine. Inone embodiment, the synthetic RNA molecule is present in vivo.

Certain non-canonical nucleotides can be incorporated more efficientlythan other non-canonical nucleotides into synthetic RNA molecules by RNApolymerases that are commonly used for in vitro transcription, due inpart to the tendency of these certain non-canonical nucleotides toparticipate in standard base-pairing interactions and base-stackinginteractions, and to interact with the RNA polymerase in a mannersimilar to that in which the corresponding canonical nucleotideinteracts with the RNA polymerase. As a result, certain nucleotidemixtures containing one or more non-canonical nucleotides can bebeneficial in part because in vitro-transcription reactions containingthese nucleotide mixtures can yield a large quantity of synthetic RNA.Certain embodiments are therefore directed to a nucleotide mixturecontaining one or more nucleotides that includes one or moresubstitutions at the 2C and/or 4C and/or 5C positions in the case of apyrimidine or the 6C and/or 7N and/or 8C positions in the case of apurine. Nucleotide mixtures include, but are not limited to (numberspreceding each nucleotide indicate an exemplary fraction of thenon-canonical nucleotide triphosphate in an in vitro-transcriptionreaction, for example, 0.2 pseudoisocytidine refers to a reactioncontaining adenosine-5-triphosphate, guanosine-5-triphosphate,uridine-5-triphosphate, cytidine-5′-triphosphate, andpseudoisocytidine-5-triphosphate, whereinpseudoisocytidine-5′-triphosphate is present in the reaction at anamount approximately equal to 0.2 times the total amount ofpseudoisocytidine-5′-triphosphate+cytidine-5-triphosphate that ispresent in the reaction, with amounts measured either on a molar or massbasis, and wherein more than one number preceding a nucleoside indicatesa range of exemplary fractions): 1.0 pseudouridine, 0.1-0.82-thiouridine, 0.1-0.8 5-methyluridine, 0.2-1.0 5-hydroxyuridine,0.1-1.0 5-aminouridine, 0.1-1.0 4-thiouridine, 0.1-1.02-thiopseudouridine, 0.1-1.0 4-thiopseudouridine, 0.1-1.05-hydroxypseudouridine, 0.2-1 5-methylpseudouridine, 0.1-1.05-aminopseudouridine, 0.2-1.0 2-thiocytidine, 0.1-0.8 pseudoisocytidine,0.2-1.0 5-methylcytidine, 0.2-1.0 5-hydroxycytidine, 0.1-1.05-aminocytidine, 0.2-1.0 N4-methylcytidine, 0.2-1.05-methylpseudoisocytidine, 0.2-1.0 5-hydroxypseudoisocytidine, 0.2-1.05-aminopseudoisocytidine, 0.2-1.0 N4-methylpseudoisocytidine, 0.2-1.02-thiopseudoisocytidine, 0.2-1.0 7-deazaguanosine, 0.2-1.06-thioguanosine, 0.2-1.0 6-thio-7-deazaguanosine, 0.2-1.08-azaguanosine, 0.2-1.0 7-deaza-8-azaguanosine, 0.2-1.06-thio-8-azaguanosine, 0.1-0.5 7-deazaadenosine, and 0.1-0.5N6-methyladenosine.

In various embodiments, the synthetic RNA composition or syntheticpolynucleotide composition (e.g., which may be prepared by in vitrotranscription) contains substantially or entirely the canonicalnucleotide at positions having adenine or “A” in the genetic code. Theterm “substantially” in this context refers to at least 90%. In theseembodiments, the synthetic RNA composition or synthetic polynucleotidecomposition may further contain (e.g., consist of) 7-deazaguanosine atpositions with “G” in the genetic code as well as the correspondingcanonical nucleotide “G”, and the canonical and non-canonical nucleotideat positions with G may be in the range of 5:1 to 1:5, or in someembodiments in the range of 2:1 to 1:2. In these embodiments, thesynthetic RNA composition or synthetic polynucleotide composition mayfurther contain (e.g., consist of) one or more (e.g., two, three orfour) of 5-hydroxymethylcytidine, 5-hydroxycytidine, 5-carboxycytidine,and 5-formylcytidine at positions with “C” in the genetic code as wellas the canonical nucleotide “C”, and the canonical and non-canonicalnucleotide at positions with C may be in the range of 5:1 to 1:5, or insome embodiments in the range of 2:1 to 1:2. In some embodiments, thelevel of non-canonical nucleotide at positions of “C” are as describedin the preceding paragraph. In these embodiments, the synthetic RNAcomposition or synthetic polynucleotide composition may further contain(e.g., consist of) one or more (e.g., two, three, or four) of5-hydroxymethyluridine, 5-hydroxyuridine, 5-carboxyurdine, and5-formyluridine at positions with “U” in the genetic code as well as thecanonical nucleotide “U”, and the canonical and non-canonical nucleotideat positions with “U” may be in the range of 5:1 to 1:5, or in someembodiments in the range of 2:1 to 1:2. In some embodiments, the levelof non-canonical nucleotide at positions of “U” are as described in thepreceding paragraph.

It has now been discovered that combining certain non-canonicalnucleotides can be beneficial in part because the contribution ofnon-canonical nucleotides to lowering the toxicity of synthetic RNAmolecules can be additive. Certain embodiments are therefore directed toa nucleotide mixture, wherein the nucleotide mixture contains more thanone of the non-canonical nucleotides listed above, for example, thenucleotide mixture contains both pseudoisocytidine and 7-deazaguanosineor the nucleotide mixture contains both N4-methylcytidine and7-deazaguanosine, etc. In one embodiment, the nucleotide mixturecontains more than one of the non-canonical nucleotides listed above,and each of the non-canonical nucleotides is present in the mixture atthe fraction listed above, for example, the nucleotide mixture contains0.1-0.8 pseudoisocytidine and 0.2-1.0 7-deazaguanosine or the nucleotidemixture contains 0.2-1.0 N4-methylcytidine and 0.2-1.0 7-deazaguanosine,etc.

In certain situations, for example, when it may not be necessary ordesirable to maximize the yield of an in vitro-transcription reaction,nucleotide fractions other than those given above may be used. Theexemplary fractions and ranges of fractions listed above relate tonucleotide-triphosphate solutions of typical purity (greater than 90%purity). Larger fractions of these and other nucleotides can be used byusing nucleotide-triphosphate solutions of greater purity, for example,greater than about 95% purity or greater than about 98% purity orgreater than about 99% purity or greater than about 99.5% purity, whichcan be achieved, for example, by purifying the nucleotide triphosphatesolution using existing chemical-purification technologies such ashigh-pressure liquid chromatography (HPLC) or by other means. In oneembodiment, nucleotides with multiple isomers are purified to enrich thedesired isomer.

Other embodiments are directed to a method for inducing a cell in vivoto express a protein of interest by contacting the cell with a syntheticRNA molecule that contains one or more non-canonical nucleotides thatincludes one or more substitutions at the 2C and/or 4C and/or 5Cpositions in the case of a pyrimidine or the 6C and/or 7N and/or 8Cpositions in the case of a purine. Still other embodiments are directedto a method for transfecting, reprogramming, and/or gene-editing a cellin vivo by contacting the cell with a synthetic RNA molecule thatcontains one or more non-canonical nucleotides that includes one or moresubstitutions at the 2C and/or 4C and/or 5C positions in the case of apyrimidine or the 6C and/or 7N and/or 8C positions in the case of apurine. In one embodiment, the synthetic RNA molecule is produced by invitro transcription. In one embodiment, the synthetic RNA moleculeencodes one or more reprogramming factors. In another embodiment, theone or more reprogramming factors includes Oct4 protein. In anotherembodiment, the cell is also contacted with a synthetic RNA moleculethat encodes Sox2 protein. In yet another embodiment, the cell is alsocontacted with a synthetic RNA molecule that encodes Klf4 protein. Inyet another embodiment, the cell is also contacted with a synthetic RNAmolecule that encodes c-Myc protein. In yet another embodiment, the cellis also contacted with a synthetic RNA molecule that encodes Lin28protein.

Enzymes such as T7 RNA polymerase may preferentially incorporatecanonical nucleotides in an in vitro-transcription reaction containingboth canonical and non-canonical nucleotides. As a result, an invitro-transcription reaction containing a certain fraction of anon-canonical nucleotide may yield RNA containing a different, oftenlower, fraction of the non-canonical nucleotide than the fraction atwhich the non-canonical nucleotide was present in the reaction. Incertain embodiments, references to nucleotide incorporation fractions(for example, “a synthetic RNA molecule containing 50%pseudoisocytidine” or “0.1-0.8 pseudoisocytidine”) therefore can referboth to RNA molecules containing the stated fraction of the nucleotide,and to RNA molecules synthesized in a reaction containing the statedfraction of the nucleotide (or nucleotide derivative, for example,nucleotide-triphosphate), even though such a reaction may yield RNAcontaining a different fraction of the nucleotide than the fraction atwhich the non-canonical nucleotide was present in the reaction.

Different nucleotide sequences can encode the same protein by utilizingalternative codons. In certain embodiments, references to nucleotideincorporation fractions therefore can refer both to RNA moleculescontaining the stated fraction of the nucleotide, and to RNA moleculesencoding the same protein as a different RNA molecule, wherein thedifferent RNA molecule contains the stated fraction of the nucleotide.

Certain embodiments are directed to a kit containing one or morematerials needed to practice the present invention. In one embodiment,the kit contains one or more synthetic RNA molecules. In one embodiment,the kit contains one or more synthetic RNA molecules that encode one ormore reprogramming factors and/or gene-editing proteins. In anotherembodiment, the one or more synthetic RNA molecules contain one or morenon-canonical nucleotides that include one or more substitutions at the2C and/or 4C and/or 5C positions in the case of a pyrimidine or the 6Cand/or 7N and/or 8C positions in the case of a purine. In anotherembodiment, the kit contains one or more of: a transfection medium, atransfection reagent, a complexation medium, and a matrix solution. Inone embodiment, the matrix solution contains fibronectin and/orvitronectin or recombinant fibronectin and/or recombinant vitronectin.In one embodiment, one or more of the components of the kit are presentas a plurality of aliquots. In one embodiment, the kit contains aliquotsof nucleic acid transfection-reagent complexes. In another embodiment,the kit contains aliquots of nucleic acid transfection-reagent complexesthat are provided in a solid form, for example, as frozen orfreeze-dried pellets. In yet another embodiment, the kit containsaliquots of medium, wherein each aliquot contains transfectionreagent-nucleic acid complexes that are stabilized either by chemicaltreatment or by freezing.

Transfection, in general, and reprogramming, in particular, can bedifficult and time-consuming techniques that can be repetitive and proneto error. However, these techniques are often performed manually due tothe lack of automated transfection equipment. Certain embodiments aretherefore directed to a system that can transfect, reprogram, and/orgene-edit cells in vivo in an automated or semi-automated manner.

It has now been discovered that the non-canonical nucleotide members ofthe 5-methylcytidine de-methylation pathway, when incorporated intosynthetic RNA, can increase the efficiency with which the synthetic RNAcan be translated into protein in vivo, and can decrease the toxicity ofthe synthetic RNA in vivo. These non-canonical nucleotides include, forexample: 5-methylcytidine, 5-hydroxymethylcytidine, 5-formylcytidine,and 5-carboxycytidine (a.k.a. “cytidine-5-carboxylic acid”). Certainembodiments are therefore directed to a nucleic acid. In someembodiments, the nucleic acid is present in vivo. In one embodiment, thenucleic acid is a synthetic RNA molecule. In another embodiment, thenucleic acid comprises one or more non-canonical nucleotides. In oneembodiment, the nucleic acid comprises one or more non-canonicalnucleotide members of the 5-methylcytidine de-methylation pathway. Inanother embodiment, the nucleic acid comprises at least one of:5-methylcytidine, 5-hydroxymethylcytidine, 5-formylcytidine, and5-carboxycytidine or a derivative thereof. In a further embodiment, thenucleic acid comprises at least one of: pseudouridine,5-methylpseudouridine, 5-hydroxyuridine, 5-methyluridine,5-methylcytidine, 5-hydroxymethylcytidine, N4-methylcytidine,N4-acetylcytidine, and 7-deazaguanosine or a derivative thereof.

5-methylcytidine De-Methylation Pathway

Certain embodiments are directed to a protein. Other embodiments aredirected to a nucleic acid that encodes a protein. In one embodiment,the protein is a protein of interest. In another embodiment, the proteinis selected from: a reprogramming protein and a gene-editing protein. Inone embodiment, the nucleic acid is a plasmid. In another embodiment,the nucleic acid is present in a virus or viral vector. In a furtherembodiment, the virus or viral vector is replication incompetent. In astill further embodiment, the virus or viral vector is replicationcompetent. In one embodiment, the virus or viral vector includes atleast one of: an adenovirus, a retrovirus, a lentivirus, a herpes virus,an adeno-associated virus or a natural or engineered variant thereof,and an engineered virus.

It has also been discovered that certain combinations of non-canonicalnucleotides can be particularly effective at increasing the efficiencywith which synthetic RNA can be translated into protein in vivo, anddecreasing the toxicity of synthetic RNA in vivo, for example, thecombinations: 5-methyluridine and 5-methylcytidine, 5-hydroxyuridine and5-methylcytidine, 5-hydroxyuridine and 5-hydroxymethylcytidine,5-methyluridine and 7-deazaguanosine, 5-methylcytidine and7-deazaguanosine, 5-methyluridine, 5-methylcytidine, and7-deazaguanosine, and 5-methyluridine, 5-hydroxymethylcytidine, and7-deazaguanosine. Certain embodiments are therefore directed to anucleic acid comprising at least two of: 5-methyluridine,5-methylcytidine, 5-hydroxymethylcytidine, and 7-deazaguanosine or oneor more derivatives thereof. Other embodiments are directed to a nucleicacid comprising at least three of: 5-methyluridine, 5-methylcytidine,5-hydroxymethylcytidine, and 7-deazaguanosine or one or more derivativesthereof. Other embodiments are directed to a nucleic acid comprising allof: 5-methyluridine, 5-methylcytidine, 5-hydroxymethylcytidine, and7-deazaguanosine or one or more derivatives thereof. In one embodiment,the nucleic acid comprises one or more 5-methyluridine residues, one ormore 5-methylcytidine residues, and one or more 7-deazaguanosineresidues or one or more 5-methyluridine residues, one or more5-hydroxymethylcytidine residues, and one or more 7-deazaguanosineresidues.

It has been further discovered that synthetic RNA molecules containingcertain fractions of certain non-canonical nucleotides and combinationsthereof can exhibit particularly high translation efficiency and lowtoxicity in vivo. Certain embodiments are therefore directed to anucleic acid comprising at least one of: one or more uridine residues,one or more cytidine residues, and one or more guanosine residues, andcomprising one or more non-canonical nucleotides. In one embodiment,between about 20% and about 80% of the uridine residues are5-methyluridine residues. In another embodiment, between about 30% andabout 50% of the uridine residues are 5-methyluridine residues. In afurther embodiment, about 40% of the uridine residues are5-methyluridine residues. In one embodiment, between about 60% and about80% of the cytidine residues are 5-methylcytidine residues. In anotherembodiment, between about 80% and about 100% of the cytidine residuesare 5-methylcytidine residues. In a further embodiment, about 100% ofthe cytidine residues are 5-methylcytidine residues. In a still furtherembodiment, between about 20% and about 100% of the cytidine residuesare 5-hydroxymethylcytidine residues. In one embodiment, between about20% and about 80% of the guanosine residues are 7-deazaguanosineresidues. In another embodiment, between about 40% and about 60% of theguanosine residues are 7-deazaguanosine residues. In a furtherembodiment, about 50% of the guanosine residues are 7-deazaguanosineresidues. In one embodiment, between about 20% and about 80% or betweenabout 30% and about 60% or about 40% of the cytidine residues areN4-methylcytidine and/or N4-acetylcytidine residues. In anotherembodiment, each cytidine residue is a 5-methylcytidine residue. In afurther embodiment, about 100% of the cytidine residues are5-methylcytidine residues and/or 5-hydroxymethylcytidine residues and/orN4-methylcytidine residues and/or N4-acetylcytidine residues and/or oneor more derivatives thereof. In a still further embodiment, about 40% ofthe uridine residues are 5-methyluridine residues, between about 20% andabout 100% of the cytidine residues are N4-methylcytidine and/orN4-acetylcytidine residues, and about 50% of the guanosine residues are7-deazaguanosine residues. In one embodiment, about 40% of the uridineresidues are 5-methyluridine residues and about 100% of the cytidineresidues are 5-methylcytidine residues. In another embodiment, about 40%of the uridine residues are 5-methyluridine residues and about 50% ofthe guanosine residues are 7-deazaguanosine residues. In a furtherembodiment, about 100% of the cytidine residues are 5-methylcytidineresidues and about 50% of the guanosine residues are 7-deazaguanosineresidues. In a further embodiment, about 100% of the uridine residuesare 5-hydroxyuridine residues. In one embodiment, about 40% of theuridine residues are 5-methyluridine residues, about 100% of thecytidine residues are 5-methylcytidine residues, and about 50% of theguanosine residues are 7-deazaguanosine residues. In another embodiment,about 40% of the uridine residues are 5-methyluridine residues, betweenabout 20% and about 100% of the cytidine residues are5-hydroxymethylcytidine residues, and about 50% of the guanosineresidues are 7-deazaguanosine residues. In some embodiments, less than100% of the cytidine residues are 5-methylcytidine residues. In otherembodiments, less than 100% of the cytidine residues are5-hydroxymethylcytidine residues. In one embodiment, each uridineresidue in the synthetic RNA molecule is a pseudouridine residue or a5-methylpseudouridine residue. In another embodiment, about 100% of theuridine residues are pseudouridine residues and/or 5-methylpseudouridineresidues. In a further embodiment, about 100% of the uridine residuesare pseudouridine residues and/or 5-methylpseudouridine residues, about100% of the cytidine residues are 5-methylcytidine residues, and about50% of the guanosine residues are 7-deazaguanosine residues.

Other non-canonical nucleotides that can be used in place of or incombination with 5-methyluridine include, but are not limited to:pseudouridine, 5-hydroxyuridine, and 5-methylpseudouridine (a.k.a.“1-methylpseudouridine”, a.k.a. “N1-methylpseudouridine”) or one or morederivatives thereof. Other non-canonical nucleotides that can be used inplace of or in combination with 5-methylcytidine and/or5-hydroxymethylcytidine include, but are not limited to:pseudoisocytidine, 5-methylpseudoisocytidine, 5-hydroxymethylcytidine,5-formylcytidine, 5-carboxycytidine, N4-methylcytidine,N4-acetylcytidine or one or more derivatives thereof. In certainembodiments, for example, when performing only a single transfection,injection or delivery or when the cells, tissue, organ or patient beingtransfected, injected or delivered to are not particularly sensitive totransfection-associated toxicity or innate-immune signaling, thefractions of non-canonical nucleotides can be reduced. Reducing thefraction of non-canonical nucleotides can be beneficial, in part,because reducing the fraction of non-canonical nucleotides can reducethe cost of the nucleic acid. In certain situations, for example, whenminimal immunogenicity of the nucleic acid is desired, the fractions ofnon-canonical nucleotides can be increased.

Enzymes such as T7 RNA polymerase may preferentially incorporatecanonical nucleotides in an in vitro-transcription reaction containingboth canonical and non-canonical nucleotides. As a result, an invitro-transcription reaction containing a certain fraction of anon-canonical nucleotide may yield RNA containing a different, oftenlower, fraction of the non-canonical nucleotide than the fraction atwhich the non-canonical nucleotide was present in the reaction. Incertain embodiments, references to nucleotide incorporation fractions(for example, “50% 5-methyluridine”) therefore can refer both to nucleicacids containing the stated fraction of the nucleotide, and to nucleicacids synthesized in a reaction containing the stated fraction of thenucleotide (or nucleotide derivative, for example,nucleotide-triphosphate), even though such a reaction may yield anucleic acid containing a different fraction of the nucleotide than thefraction at which the non-canonical nucleotide was present in thereaction. In addition, different nucleotide sequences can encode thesame protein by utilizing alternative codons. In certain embodiments,references to nucleotide incorporation fractions therefore can referboth to nucleic acids containing the stated fraction of the nucleotide,and to nucleic acids encoding the same protein as a different nucleicacid, wherein the different nucleic acid contains the stated fraction ofthe nucleotide.

The DNA sequence of a cell can be altered by contacting the cell with agene-editing protein or by inducing the cell to express a gene-editingprotein. However, previously disclosed gene-editing proteins suffer fromlow binding efficiency and excessive off-target activity, which canintroduce undesired mutations in the DNA of the cell, severely limitingtheir use in vivo, for example in therapeutic and cosmetic applications,in which the introduction of undesired mutations in a patient's cellscould lead to the development of cancer. It has now been discovered thatgene-editing proteins that comprise the Stsl endonuclease cleavagedomain (SEQ ID NO: 1) can exhibit substantially lower off-targetactivity in vivo than previously disclosed gene-editing proteins, whilemaintaining a high level of on-target activity in vivo. Other novelengineered proteins have also been discovered that can exhibit highon-target activity in vivo, low off-target activity in vivo, small size,solubility, and other desirable characteristics when they are used asthe nuclease domain of a gene-editing protein: Stsl-HA (SEQ ID NO: 2),Stsl-HA2 (SEQ ID NO: 3), Stsl-UHA (SEQ ID NO: 4), Stsl-UHA2 (SEQ ID NO:5), Stsl-HF (SEQ ID NO: 6), and Stsl-UHF (SEQ ID NO: 7). Stsl-HA,Stsl-HA2 (high activity), Stsl-UHA, and Stsl-UHA2 (ultra-high activity)can exhibit higher on-target activity in vivo than both wild-type Stsland wild-type Fokl, due in part to specific amino-acid substitutionswithin the N-terminal region at the 34 and 61 positions, while Stsl-HF(high fidelity) and Stsl-UHF (ultra-high fidelity) can exhibit loweroff-target activity in vivo than both wild-type Stsl and wild-type Fokl,due in part to specific amino-acid substitutions within the C-terminalregion at the 141 and 152 positions.

Certain embodiments are therefore directed to a protein. In someembodiments, the protein is present in vivo. In other embodiments, theprotein comprises a nuclease domain. In one embodiment, the nucleasedomain comprises one or more of: the cleavage domain of Foklendonuclease (SEQ ID NO: 53), the cleavage domain of Stsl endonuclease(SEQ ID NO: 1), Stsl-HA (SEQ ID NO: 2), Stsl-HA2 (SEQ ID NO: 3),Stsl-UHA (SEQ ID NO: 4), Stsl-UHA2 (SEQ ID NO: 5), Stsl-HF (SEQ ID NO:6), and Stsl-UHF (SEQ ID NO: 7) or a biologically active fragment orvariant thereof.

It has also been discovered that engineered gene-editing proteins thatcomprise DNA-binding domains comprising certain novel repeat sequencescan exhibit lower off-target activity in vivo than previously disclosedgene-editing proteins, while maintaining a high level of on-targetactivity in vivo. Certain of these engineered gene-editing proteins canprovide several advantages over previously disclosed gene-editingproteins, including, for example, increased flexibility of the linkerregion connecting repeat sequences, which can result in increasedbinding efficiency. Certain embodiments are therefore directed to aprotein comprising a plurality of repeat sequences. In one embodiment,at least one of the repeat sequences contains the amino-acid sequence:GabG, where “a” and “b” each represent any amino acid. In oneembodiment, the protein is a gene-editing protein. In anotherembodiment, one or more of the repeat sequences are present in aDNA-binding domain. In a further embodiment, “a” and “b” are eachindependently selected from the group: H and G. In a still furtherembodiment, “a” and “b” are H and G, respectively. In one embodiment,the amino-acid sequence is present within about 5 amino acids of theC-terminus of the repeat sequence. In another embodiment, the amino-acidsequence is present at the C-terminus of the repeat sequence. In someembodiments, one or more G in the amino-acid sequence GabG is replacedwith one or more amino acids other than G, for example A, H or GG. Inone embodiment, the repeat sequence has a length of between about 32 andabout 40 amino acids or between about 33 and about 39 amino acids orbetween about 34 and 38 amino acids or between about 35 and about 37amino acids or about 36 amino acids or greater than about 32 amino acidsor greater than about 33 amino acids or greater than about 34 aminoacids or greater than about 35 amino acids. Other embodiments aredirected to a protein comprising one or more transcriptionactivator-like effector domains. In one embodiment, at least one of thetranscription activator-like effector domains comprises a repeatsequence. Other embodiments are directed to a protein comprising aplurality of repeat sequences generated by inserting one or more aminoacids between at least two of the repeat sequences of a transcriptionactivator-like effector domain. In one embodiment, one or more aminoacids is inserted about 1 or about 2 or about 3 or about 4 or about 5amino acids from the C-terminus of at least one repeat sequence. Stillother embodiments are directed to a protein comprising a plurality ofrepeat sequences, wherein about every other repeat sequence has adifferent length than the repeat sequence immediately preceding orfollowing the repeat sequence. In one embodiment, every other repeatsequence is about 36 amino acids long. In another embodiment, everyother repeat sequence is 36 amino acids long. Still other embodimentsare directed to a protein comprising a plurality of repeat sequences,wherein the plurality of repeat sequences comprises at least two repeatsequences that are each at least 36 amino acids long, and wherein atleast two of the repeat sequences that are at least 36 amino acids longare separated by at least one repeat sequence that is less than 36 aminoacids long. Some embodiments are directed to a protein that comprisesone or more sequences selected from, for example, SEQ ID NO: 54, SEQ IDNO: 55, SEQ ID NO: 56, SEQ ID NO: 57, SEQ ID NO: 58, SEQ ID NO: 59, andSEQ ID NO: 60.

Other embodiments are directed to a protein that comprises a DNA-bindingdomain. In some embodiments, the DNA-binding domain comprises aplurality of repeat sequences. In one embodiment, the plurality ofrepeat sequences enables high-specificity recognition of a binding sitein a target DNA molecule. In another embodiment, at least two of therepeat sequences have at least about 50%, or about 60%, or about 70%, orabout 80%, or about 90%, or about 95%, or about 98%, or about 99%homology to each other. In a further embodiment, at least one of therepeat sequences comprises one or more regions capable of binding to abinding site in a target DNA molecule. In a still further embodiment,the binding site comprises a defined sequence of between about 1 toabout 5 bases in length. In one embodiment, the DNA-binding domaincomprises a zinc finger. In another embodiment, the DNA-binding domaincomprises a transcription activator-like effector (TALE). In a furtherembodiment, the plurality of repeat sequences includes at least onerepeat sequence having at least about 50% or about 60% or about 70% orabout 80% or about 90% or about 95% or about 98%, or about 99% homologyto a TALE. In a still further embodiment, the gene-editing proteincomprises a clustered regularly interspaced short palindromic repeat(CRISPR)-associated protein. In one embodiment, the gene-editing proteincomprises a nuclear-localization sequence. In another embodiment, thenuclear-localization sequence comprises the amino-acid sequence:PKKKRKV. In one embodiment, the gene-editing protein comprises amitochondrial-localization sequence. In another embodiment, themitochondrial-localization sequence comprises the amino-acid sequence:LGRVIPRKIASRASLM. In one embodiment, the gene-editing protein comprisesa linker. In another embodiment, the linker connects a DNA-bindingdomain to a nuclease domain. In a further embodiment, the linker isbetween about 1 and about 10 amino acids long. In some embodiments, thelinker is about 1, about 2, or about 3, or about 4, or about 5, or about6, or about 7, or about 8, or about 9, or about 10 amino acids long. Inone embodiment, the gene-editing protein is capable of generating a nickor a double-strand break in a target DNA molecule.

Certain embodiments are directed to a method for modifying the genome ofa cell in vivo, the method comprising introducing into a cell in vivo anucleic acid molecule encoding a non-naturally occurring fusion proteincomprising an artificial transcription activator-like (TAL) effectorrepeat domain comprising one or more repeat units 36 amino acids inlength and an endonuclease domain, wherein the repeat domain isengineered for recognition of a predetermined nucleotide sequence, andwherein the fusion protein recognizes the predetermined nucleotidesequence. In one embodiment, the cell is a eukaryotic cell. In anotherembodiment, the cell is an animal cell. In a further embodiment, thecell is a mammalian cell. In a still further embodiment, the cell is ahuman cell. In one embodiment, the cell is a plant cell. In anotherembodiment, the cell is a prokaryotic cell. In some embodiments, thefusion protein introduces an endonucleolytic cleavage in a nucleic acidof the cell, whereby the genome of the cell is modified.

Certain embodiments are directed to a composition for altering the DNAsequence of a cell in vivo comprising a nucleic acid, wherein thenucleic acid encodes a gene-editing protein. Other embodiments aredirected to a composition for altering the DNA sequence of a cell invivo comprising a nucleic-acid mixture, wherein the nucleic-acid mixturecomprises: a first nucleic acid that encodes a first gene-editingprotein, and a second nucleic acid that encodes a second gene-editingprotein. In one embodiment, the binding site of the first gene-editingprotein and the binding site of the second gene-editing protein arepresent in the same target DNA molecule. In another embodiment, thebinding site of the first gene-editing protein and the binding site ofthe second gene-editing protein are separated by less than about 50bases, or less than about 40 bases, or less than about 30 bases or lessthan about 20 bases, or less than about 10 bases, or between about 10bases and about 25 bases or about 15 bases. In one embodiment, thenuclease domain of the first gene-editing protein and the nucleasedomain of the second gene-editing protein are capable of forming adimer. In another embodiment, the dimer is capable of generating a nickor double-strand break in a target DNA molecule.

Certain embodiments are directed to a therapeutic composition. Otherembodiments are directed to a cosmetic composition. In some embodiments,the composition comprises a repair template. In a further embodiment,the repair template is a single-stranded DNA molecule or adouble-stranded DNA molecule.

Other embodiments are directed to an article of manufacture forsynthesizing a protein or a nucleic acid encoding a protein. In oneembodiment, the article is a nucleic acid. In another embodiment, theprotein comprises a DNA-binding domain. In a further embodiment, thenucleic acid comprises a nucleotide sequence encoding a DNA-bindingdomain. In one embodiment, the protein comprises a nuclease domain. Inanother embodiment, the nucleic acid comprises a nucleotide sequenceencoding a nuclease domain. In one embodiment, the protein comprises aplurality of repeat sequences. In another embodiment, the nucleic acidencodes a plurality of repeat sequences. In a further embodiment, thenuclease domain is selected from: Fokl, Stsl, Stsl-HA, Stsl-HA2,Stsl-UHA, Stsl-UHA2, Stsl-HF, and Stsl-UHF or a natural or engineeredvariant or biologically active fragment thereof. In one embodiment, thenucleic acid comprises an RNA-polymerase promoter. In anotherembodiment, the RNA-polymerase promoter is a T7 promoter or a SP6promoter. In a further embodiment, the nucleic acid comprises a viralpromoter. In one embodiment, the nucleic acid comprises an untranslatedregion. In another embodiment, the nucleic acid is an invitro-transcription template.

Certain embodiments are directed to a method for inducing a cell toexpress a protein in vivo. Other embodiments are directed to a methodfor altering the DNA sequence of a cell in vivo comprising transfectingthe cell in vivo with a gene-editing protein or inducing the cell toexpress a gene-editing protein in vivo. Still other embodiments aredirected to a method for reducing the expression of a protein ofinterest in a cell in vivo. In one embodiment, the cell is induced toexpress a gene-editing protein, wherein the gene-editing protein iscapable of creating a nick or a double-strand break in a target DNAmolecule. In another embodiment, the nick or double-strand break resultsin inactivation of a gene. Still other embodiments are directed to amethod for generating an inactive, reduced-activity or dominant-negativeform of a protein in vivo. In one embodiment, the protein is survivin.Still other embodiments are directed to a method for repairing one ormore mutations in a cell in vivo. In one embodiment, the cell iscontacted with a repair template. In another embodiment, the repairtemplate is a DNA molecule. In a further embodiment, the repair templatedoes not contain a binding site of the gene-editing protein. In a stillfurther embodiment, the repair template encodes an amino-acid sequencethat is encoded by a DNA sequence that comprises a binding site of thegene-editing protein.

Other embodiments are directed to a method for treating a patientcomprising administering to the patient a therapeutically orcosmetically effective amount of a protein or a nucleic acid encoding aprotein. In one embodiment, the treatment results in one or more of thepatient's symptoms being ameliorated. Certain embodiments are directedto a method for treating a patient comprising: a. inducing a cell toexpress a protein of interest by transfecting the cell in vivo with anucleic acid encoding the protein of interest and/or b. reprogrammingthe cell in vivo. In one embodiment, the cell is reprogrammed to a lessdifferentiated state. In another embodiment, the cell is reprogrammed bytransfecting the cell with one or more synthetic RNA molecules encodingone or more reprogramming proteins. In a further embodiment, the cell isdifferentiated. In a still further embodiment, the cell isdifferentiated into one of: a skin cell, a glucose-responsiveinsulin-producing cell, a hematopoietic cell, a cardiac cell, a retinalcell, a renal cell, a neural cell, a stromal cell, a fat cell, a bonecell, a muscle cell, an oocyte, and a sperm cell. Other embodiments aredirected to a method for treating a patient comprising: a. inducing acell to express a gene-editing protein by transfecting the cell in vivowith a nucleic acid encoding a gene-editing protein and/or b.reprogramming the cell in vivo.

Other embodiments are directed to a complexation medium. In oneembodiment, the complexation medium has a pH greater than about 7, orgreater than about 7.2, or greater than about 7.4, or greater than about7.6, or greater than about 7.8, or greater than about 8.0, or greaterthan about 8.2, or greater than about 8.4, or greater than about 8.6, orgreater than about 8.8, or greater than about 9.0. In anotherembodiment, the complexation medium comprises transferrin. In a furtherembodiment, the complexation medium comprises DMEM. In a still furtherembodiment, the complexation medium comprises DMEM/F12. Still otherembodiments are directed to a method for formingnucleic-acid-transfection-reagent complexes. In one embodiment, thetransfection reagent is incubated with a complexation medium. In anotherembodiment, the incubation occurs before a mixing step. In a furtherembodiment, the incubation step is between about 5 seconds and about 5minutes or between about 10 seconds and about 2 minutes or between about15 seconds and about 1 minute or between about 30 seconds and about 45seconds. In one embodiment, the transfection reagent is selected fromTable 2. In another embodiment, the transfection reagent is a lipid orlipidoid. In a further embodiment, the transfection reagent comprises acation. In a still further embodiment, the cation is a multivalentcation. In a still further embodiment, the transfection reagent isN1-[2-((1S)-1-[(3-aminopropyl)amino]-4-[di(3-amino-propyl)amino]butylcarboxamido)ethyl]-3,4-di[oleyloxy]-benzamide(a.k.a. MVL5) or a derivative thereof.

Certain embodiments are directed to a method for inducing a cell toexpress a protein by contacting the cell with a nucleic acid in vivo. Inone embodiment, the cell is a mammalian cell. In another embodiment, thecell is a human cell or a rodent cell. Other embodiments are directed toa cell produced using one or more of the methods of the presentinvention. In one embodiment, the cell is present in a patient. Inanother embodiment, the cell is isolated from a patient. Otherembodiments are directed to a screening library comprising a cellproduced using one or more of the methods of the present invention. Inone embodiment, the screening library is used for at least one of:toxicity screening, including: cardiotoxicity screening, neurotoxicityscreening, and hepatotoxicity screening, efficacy screening,high-throughput screening, high-content screening, and other screening.

Other embodiments are directed to a kit containing a nucleic acid. Inone embodiment, the kit contains a delivery reagent (a.k.a.“transfection reagent”). In another embodiment, the kit is areprogramming kit. In a further embodiment, the kit is a gene-editingkit. Other embodiments are directed to a kit for producing nucleicacids. In one embodiment, the kit contains at least two of:pseudouridine-triphosphate, 5-methyluridine triphosphate,5-methylcytidine triphosphate, 5-hydroxymethylcytidine triphosphate,N4-methylcytidine triphosphate, N4-acetylcytidine triphosphate, and7-deazaguanosine triphosphate or one or more derivatives thereof. Otherembodiments are directed to a therapeutic or cosmetic comprising anucleic acid. In one embodiment, the therapeutic or cosmetic is apharmaceutical composition. In another embodiment, the pharmaceuticalcomposition is formulated. In a further embodiment, the formulationcomprises an aqueous suspension of liposomes. Example liposomecomponents are set forth in Table 2, and are given by way of example,and not by way of limitation. In one embodiment, the liposomes includeone or more polyethylene glycol (PEG) chains. In another embodiment, thePEG is PEG2000. In a further embodiment, the liposomes include1,2-distearoyl-sn-glycero-3-phosphoethanolamine (DSPE) or a derivativethereof. In one embodiment, the therapeutic comprises one or moreligands. In another embodiment, the therapeutic comprises at least oneof: androgen, CD30 (TNFRSF8), a cell-penetrating peptide, CXCR,estrogen, epidermal growth factor, EGFR, HER2, folate, insulin,insulin-like growth factor-I, interleukin-13, integrin, progesterone,stromal-derived-factor-1, thrombin, vitamin D, and transferrin or abiologically active fragment or variant thereof. Still other embodimentsare directed to a therapeutic or cosmetic comprising a cell generatedusing one or more of the methods of the present invention. In oneembodiment, the therapeutic is administered to a patient for thetreatment of at least one of: type 1 diabetes, heart disease, includingischemic and dilated cardiomyopathy, macular degeneration, Parkinson'sdisease, cystic fibrosis, sickle-cell anemia, thalassemia, Fanconianemia, severe combined immunodeficiency, hereditary sensory neuropathy,xeroderma pigmentosum, Huntington's disease, muscular dystrophy,amyotrophic lateral sclerosis, Alzheimer's disease, cancer, andinfectious diseases including: hepatitis and HIV/AIDS.

TABLE 2 Illustrative Biocompatible Lipids 13β-[N-(N′,N′-dimethylaminoethane)-carbamoyl]cholesterol (DC-Cholesterol)2 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP/18:1 TAP) 3N-(4-carboxybenzyl)-N,N-dimethyl-2,3-bis(oleoyloxy)propan-1- aminium(DOBAQ) 4 1,2-dimyristoyl-3-trimethylammonium-propane (14:0 TAP) 51,2-dipalmitoyl-3-trimethylammonium-propane (16:0 TAP) 61,2-stearoyl-3-trimethylammonium-propane (18:0 TAP) 71,2-dioleoyl-3-dimethylammonium-propane (DODAP/18:1 DAP) 81,2-dimyristoyl-3-dimethylammonium-propane (14:0 DAP) 91,2-dipalmitoyl-3-dimethylammonium-propane (16:0 DAP) 101,2-distearoyl-3-dimethylammonium-propane (18:0 DAP) 11dimethyldioctadecylammonium (18:0 DDAB) 121,2-dilauroyl-sn-glycero-3-ethylphosphocholine (12:0 EthylPC) 131,2-dimyristoyl-sn-glycero-3-ethylphosphocholine (14:0 EthylPC) 141,2-dimyristoleoyl-sn-glycero-3-ethylphosphocholine (14:1 EthylPC) 151,2-dipalmitoyl-sn-glycero-3-ethylphosphocholine (16:0 EthylPC) 161,2-distearoyl-sn-glycero-3-ethylphosphocholine (18:0 EthylPC) 171,2-dioleoyl-sn-glycero-3-ethylphosphocholine (18:1 EthylPC) 181-palmitoyl-2-oleoyl-sn-glycero-3-ethylphosphocholine (16:1-18:1EthylPC) 19 1,2-di-O-octadecenyl-3-trimethylammonium propane (DOTMA) 20N1-[2-((1S)-1-[(3-aminopropyl)amino]-4-[di(3-amino-propyl)amino]butylcarboxamido)ethyl]-3,4-di[oleyloxy]- benzamide (MVL5)21 2,3-dioleyloxy-N-[2-spermine carboxamide]ethyl-N,N-dimethyl-1-propanammonium trifluoroacetate (DOSPA) 221,3-di-oleoyloxy-2-(6-carboxy-spermyl)-propylamid (DOSPER) 23N-[1-(2,3-dimyristyloxy)propyl]-N,N-dimethyl-N-(2-hydroxy-ethyl)ammonium bromide (DMRIE) 24 dioctadecyl amidoglyceryl spermine(DOGS) 25 dioleoyl phosphatidyl ethanolamine (DOPE)

In some embodiments, the present invention relates to one or moreadministration techniques described in U.S. Pat. Nos. 5,711,964;5,891,468; 6,316,260; 6,413,544; 6,770,291; and 7,390,780, the entirecontents of which are hereby incorporated by reference in theirentireties.

Certain embodiments are directed to a nucleic acid comprising a 5′-capstructure selected from Cap 0, Cap 1, Cap 2, and Cap 3 or a derivativethereof. In one embodiment, the nucleic acid comprises one or more UTRs.In another embodiment, the one or more UTRs increase the stability ofthe nucleic acid. In a further embodiment, the one or more UTRs comprisean alpha-globin or beta-globin 5′-UTR. In a still further embodiment,the one or more UTRs comprise an alpha-globin or beta-globin 3′-UTR. Ina still further embodiment, the synthetic RNA molecule comprises analpha-globin or beta-globin 5′-UTR and an alpha-globin or beta-globin3′-UTR. In one embodiment, the 5′-UTR comprises a Kozak sequence that issubstantially similar to the Kozak consensus sequence. In anotherembodiment, the nucleic acid comprises a 3-poly(A) tail. In a furtherembodiment, the 3′-poly(A) tail is between about 20 nt and about 250 ntor between about 120 nt and about 150 nt long. In a further embodiment,the 3′-poly(A) tail is about 20 nt, or about 30 nt, or about 40 nt, orabout 50 nt, or about 60 nt, or about 70 nt, or about 80 nt, or about 90nt, or about 100 nt, or about 110 nt, or about 120 nt, or about 130 nt,or about 140 nt, or about 150 nt, or about 160 nt, or about 170 nt, orabout 180 nt, or about 190 nt, or about 200 nt, or about 210 nt, orabout 220 nt, or about 230 nt, or about 240 nt, or about 250 nt long.

Other embodiments are directed to a method for reprogramming a cell invivo. In one embodiment, the cell is reprogrammed by contacting the cellwith one or more nucleic acids. In one embodiment, the cell is contactedwith a plurality of nucleic acids encoding at least one of: Oct4protein, Sox2 protein, Klf4 protein, c-Myc protein, Lin28 protein or abiologically active fragment, variant or derivative thereof. In anotherembodiment, the cell is contacted with a plurality of nucleic acidsencoding a plurality of proteins including: Oct4 protein, Sox2 protein,Klf4 protein, and c-Myc protein or one or more biologically activefragments, variants or derivatives thereof. Still other embodiments aredirected to a method for gene editing a cell in vivo. In one embodiment,the cell is gene-edited by contacting the cell with one or more nucleicacids.

Nucleic acids, including liposomal formulations containing nucleicacids, when delivered in vivo, can accumulate in the liver and/orspleen. It has now been discovered that nucleic acids encoding proteinscan modulate protein expression in the liver and spleen, and thatnucleic acids used in this manner can constitute potent therapeutics forthe treatment of liver and spleen diseases. Certain embodiments aretherefore directed to a method for treating liver and/or spleen diseaseby delivering to a patient a nucleic acid encoding a protein ofinterest. Other embodiments are directed to a therapeutic compositioncomprising a nucleic acid encoding a protein of interest, for thetreatment of liver and/or spleen disease. Diseases and conditions of theliver and/or spleen that can be treated include, but are not limited to:hepatitis, alcohol-induced liver disease, drug-induced liver disease,Epstein Barr virus infection, adenovirus infection, cytomegalovirusinfection, toxoplasmosis, Rocky Mountain spotted fever, non-alcoholicfatty liver disease, hemochromatosis, Wilson's Disease, Gilbert'sDisease, and cancer of the liver and/or spleen.

Certain embodiments are directed to a method for inducing a cell in vivoto express a protein of interest comprising contacting a cell in vivowith a solution comprising albumin that is treated with an ion-exchangeresin or charcoal and one or more nucleic acid molecules, wherein atleast one of the one or more nucleic acid molecules encodes a protein ofinterest. In one embodiment, the method results in the cell expressingthe protein of interest. In another embodiment, the one or more nucleicacid molecules comprise a synthetic RNA molecule. In one embodiment, thecell is a skin cell. In another embodiment, the cell is a muscle cell.In yet another embodiment, the cell is a dermal fibroblast. In yetanother embodiment, the cell is a myoblast. In one embodiment, theprotein of interest is an extracellular matrix protein. In anotherembodiment, the protein of interest is selected from: elastin, collagen,laminin, fibronectin, vitronectin, lysyl oxidase, elastin bindingprotein, a growth factor, fibroblast growth factor, transforming growthfactor beta, granulocyte colony-stimulating factor, a matrixmetalloproteinase, an actin, fibrillin, microfibril-associatedglycoprotein, a lysyl-oxidase-like protein, and platelet-derived growthfactor. In one embodiment, the solution is delivered to the dermis. Inanother embodiment, the delivering is by injection. In yet anotherembodiment, the delivering is by injection using a microneedle array. Inone embodiment, the solution further comprises a growth factor. Inanother embodiment, the growth factor is selected from: fibroblastgrowth factor and transforming growth factor beta. In yet anotherembodiment, the solution further comprises cholesterol.

Other embodiments are directed a method for inducing a cell in vivo toexpress a protein of interest comprising contacting a cell in vivo witha solution comprising cholesterol and one or more nucleic acidmolecules, wherein at least one of the one or more nucleic acidmolecules encodes a protein of interest. In one embodiment, the methodresults in the cell expressing the protein of interest. Still otherembodiments are directed to a method for transfecting a cell in vivowith a nucleic acid molecule comprising contacting a cell in vivo with asolution comprising albumin that is treated with an ion-exchange resinor charcoal and a nucleic acid molecule. In one embodiment, the methodresults in the cell being transfected with the nucleic acid molecule. Inanother embodiment, the nucleic acid molecule is one of: a dsDNAmolecule, a ssDNA molecule, a dsRNA molecule, a ssRNA molecule, aplasmid, an oligonucleotide, a synthetic RNA molecule, a miRNA molecule,an mRNA molecule, an siRNA molecule. Still other embodiments aredirected to a method for treating a patient comprising delivering to apatient a composition comprising albumin that is treated with anion-exchange resin or charcoal and one or more nucleic acid molecules,wherein at least one of the one or more nucleic acid molecules encodes aprotein of interest. In one embodiment, the method results in theexpression of the protein of interest in the patient. In anotherembodiment, the method results in the expression of the protein ofinterest in the dermis of the patient.

Certain embodiments are directed to a cosmetic composition comprisingalbumin that is treated with an ion-exchange resin or charcoal and anucleic acid molecule. Other embodiments are directed to a cosmetictreatment article. In one embodiment, the cosmetic treatment articlecomprises a device configured to deliver a composition to a patient. Inanother embodiment, the nucleic acid molecule encodes elastin protein orcollagen protein. Still other embodiments are directed to a solution fortransfecting a cell in vivo comprising cholesterol or a cholesterolanalog and one or more nucleic acid molecules. In one embodiment, thecholesterol or cholesterol analog is covalently bound to at least one ofthe one or more nucleic acid molecules. In another embodiment, thecholesterol analog is an oxysterol. In yet another embodiment, thecholesterol analog includes one or more of: an A-ring substitution, aB-ring substitution, a D-ring substitution, a side-chain substitution, acholestanoic acid, a cholestenoic acid, a polyunsaturated moiety, adeuterated moiety, a fluorinated moiety, a sulfonated moiety, aphosphorylated moiety, and a fluorescent moiety. In yet anotherembodiment, the method comprises treating the patient with one or moreof: a dermal filler, a neurotoxin (by way of illustration sodium channelinhibitors (e.g., tetrodotoxin), potassium channel inhibitors (e.g.,tetraethylammonium), chloride channel inhibitors (e.g., chlorotoxin andcurare), calcium channel inhibitors (e.g., conotoxin), synaptic vesiclerelease inhibitors (e.g., botulinum toxin and tetanus toxin) and bloodbrain barrier inhibitor (e.g., aluminum and mercury)) and arepair-inducing treatment.

For instance, botulinum toxin type A has been approved by the U.S. Foodand Drug Administration (FDA) for the treatment of essentialblepharospasm, strabismus and hemifacial spasm in patients over the ageof twelve, cervical dystonia, glabellar line (facial) wrinkles and fortreating hyperhydrosis and botulinum toxin type B has been approved forthe treatment of cervical dystonia. The present compositions may becombined with these toxins in the treatment of these diseases.

Further the combination of any one of the aforementioned toxins may beused in combination with the present compositions for various cosmeticprocedures, including, without limitation, facial wrinkles, hyperkineticskin lines, glabellar lines, crow's feet, marionette lines, skindisorders, nasolabial folds, blepharospasm, strabismus, hemifacialspasms and sweating disorders. Alternatively, the present compositionsmay be used to in these cosmetic procedures as a monotherapy.

Certain embodiments are directed to a combination therapy comprising oneor more of the therapeutic or cosmetic compositions of the presentinvention and one or more adjuvant therapies or cosmetic treatments. Incertain embodiments, one or more of the therapeutic or cosmeticcompositions of the present invention are administered to a subjectwhich is undergoing treatment with one or more adjuvant therapies orcosmetic treatments. Example adjuvant therapies and cosmetic treatmentsare set forth in Table 3 and Table 5 of U.S. Provisional Application No.61/721,302, the contents of which are hereby incorporated by reference,and are given by way of example, and not by way of limitation.

TABLE 3 Illustrative Adjuvant Therapies Example Therapy/Treatment ClassDisease/Condition Therapy/Treatment Acetylcholinesterase inhibitorsMyasthenia gravis, Glaucoma, Edrophonium Alzheimer's disease, Lewy bodydementia, Postural tachycardia syndrome Angiotensin-converting-enzymeHypertension, Congestive heart failure Perindopril inhibitor Alkylatingagents Cancer Cisplatin Angiogenesis inhibitors Cancer, Maculardegeneration Bevacizumab Angiotensin II receptor antagonistsHypertension, Diabetic nephropathy, Valsartan Congestive heart failureAntibiotics Bacterial infection Amoxicillin Antidiabetic drugs DiabetesMetformin Antimetabolites Cancer, Infection 5-fluorouracil (5FU)Antisense oligonucleotides Cancer, Diabetes, Amyotrophic lateralMipomersen sclerosis (ALS), Hypercholesterolemia Cytotoxic antibioticsCancer Doxorubicin Deep-brain stimulation Chronic pain, Parkinson'sdisease, N/A Tremor, Dystonia Dopamine agonists Parkinson's disease,Type II diabetes, Bromocriptine Pituitary tumors Entry/Fusion inhibitorsHIV/AIDS Maraviroc Glucagon-like peptide-1 agonists Diabetes ExenatideGlucocorticoids Asthma, Adrenal insufficiency, DexamethasoneInflammatory diseases, Immune diseases, Bacterial meningitisImmunosuppressive drugs Organ transplantation, Inflammatory Azathioprinediseases, Immune diseases Insulin/Insulin analogs Diabetes NPH insulinIntegrase inhibitors HIV/AIDS Raltegravir MAO-B inhibitors Parkinson'sdisease, Depression, Selegiline Dementia Maturation inhibitors HIV/AIDSBevirimat Nucleoside analog reverse- HIV/AIDS, Hepatitis B Lamivudinetranscriptase inhibitors Nucleotide analog reverse- HIV/AIDS, HepatitisB Tenofovir transcriptase inhibitors Non-nucleosidereverse-transcriptase HIV/AIDS Rilpivirine inhibitors Pegylatedinterferon Hepatitis B/C, Multiple sclerosis Interferon beta-1a Plantalkaloids/terpenoids Cancer Paclitaxel Protease inhibitors HIV/AIDS,Hepatitis C, Other viral Telaprevir infections Radiotherapy CancerBrachytherapy Renin inhibitors Hypertension Aliskiren StatinsHypercholesterolemia Atorvastatin Topoisomerase inhibitors CancerTopotecan Vasopressin receptor antagonist Hyponatremia, Kidney diseaseTolvaptan Dermal filler Wrinkles, aged skin Hyaluronic Acid Botulinumtoxin Wrinkles, aged skin botulinum toxin type A Induction of skinrepair Acne scars, aged skin Laser treatment, dermabrasion

Pharmaceutical preparations may additionally comprise delivery reagents(a.k.a. “transfection reagents”) and/or excipients. Pharmaceuticallyacceptable delivery reagents, excipients, and methods of preparation anduse thereof, including methods for preparing and administeringpharmaceutical preparations to patients (a.k.a. “subjects”) are wellknown in the art, and are set forth in numerous publications, including,for example, in US Patent Appl. Pub. No. US 2008/0213377, the entiretyof which is incorporated herein by reference.

For example, the present compositions can be in the form ofpharmaceutically acceptable salts. Such salts include those listed in,for example, J. Pharma. Sci. 66, 2-19 (1977) and The Handbook ofPharmaceutical Salts; Properties, Selection, and Use. P. H. Stahl and C.G. Wermuth (eds.), Verlag, Zurich (Switzerland) 2002, which are herebyincorporated by reference in their entirety. Non-limiting examples ofpharmaceutically acceptable salts include: sulfate, citrate, acetate,oxalate, chloride, bromide, iodide, nitrate, bisulfate, phosphate, acidphosphate, isonicotinate, lactate, salicylate, acid citrate, tartrate,oleate, tannate, pantothenate, bitartrate, ascorbate, succinate,maleate, gentisinate, fumarate, gluconate, glucaronate, saccharate,formate, benzoate, glutamate, methanesulfonate, ethanesulfonate,benzenesulfonate, p-toluenesulfonate, camphorsulfonate, pamoate,phenylacetate, trifluoroacetate, acrylate, chlorobenzoate,dinitrobenzoate, hydroxybenzoate, methoxybenzoate, methylbenzoate,o-acetoxybenzoate, naphthalene-2-benzoate, isobutyrate, phenylbutyrate,α-hydroxybutyrate, butyne-1,4-dicarboxylate, hexyne-1,4-dicarboxylate,caprate, caprylate, cinnamate, glycollate, heptanoate, hippurate,malate, hydroxymaleate, malonate, mandelate, mesylate, nicotinate,phthalate, teraphthalate, propiolate, propionate, phenylpropionate,sebacate, suberate, p-bromobenzenesulfonate, chlorobenzenesulfonate,ethylsulfonate, 2-hydroxyethylsulfonate, methylsulfonate,naphthalene-1-sulfonate, naphthalene-2-sulfonate,naphthalene-1,5-sulfonate, xylenesulfonate, tartarate salts, hydroxidesof alkali metals such as sodium, potassium, and lithium; hydroxides ofalkaline earth metal such as calcium and magnesium; hydroxides of othermetals, such as aluminum and zinc; ammonia, and organic amines, such asunsubstituted or hydroxy-substituted mono-, di-, or tri-alkylamines,dicyclohexylamine; tributyl amine; pyridine; N-methyl, N-ethylamine;diethylamine; triethylamine; mono-, bis-, or tris-(2-OH-loweralkylamines), such as mono-; bis-, or tris-(2-hydroxyethyl)amine,2-hydroxy-tert-butylamine, or tris-(hydroxymethyl)methylamine,N,N-di-lower alkyl-N-(hydroxyl-lower alkyl)-amines, such asN,N-dimethyl-N-(2-hydroxyethyl)amine or tri-(2-hydroxyethyl)amine;N-methyl-D-glucamine; and amino acids such as arginine, lysine, and thelike.

The present pharmaceutical compositions can comprises excipients,including liquids such as water and oils, including those of petroleum,animal, vegetable, or synthetic origin, such as peanut oil, soybean oil,mineral oil, sesame oil and the like. The pharmaceutical excipients canbe, for example, saline, gum acacia, gelatin, starch paste, talc,keratin, colloidal silica, urea and the like. In addition, auxiliary,stabilizing, thickening, lubricating, and coloring agents can be used.In one embodiment, the pharmaceutically acceptable excipients aresterile when administered to a subject. Suitable pharmaceuticalexcipients also include starch, glucose, lactose, sucrose, gelatin,malt, rice, flour, chalk, silica gel, sodium stearate, glycerolmonostearate, talc, sodium chloride, dried skim milk, glycerol,propylene, glycol, water, ethanol and the like. Any agent describedherein, if desired, can also comprise minor amounts of wetting oremulsifying agents, or pH buffering agents.

In various embodiments, the compositions described herein canadministered in an effective dose of, for example, from about 1 mg/kg toabout 100 mg/kg, about 2.5 mg/kg to about 50 mg/kg, or about 5 mg/kg toabout 25 mg/kg. The precise determination of what would be considered aneffective dose may be based on factors individual to each patient,including their size, age, and type of disease. Dosages can be readilyascertained by those of ordinary skill in the art from this disclosureand the knowledge in the art. For example, doses may be determined withreference Physicians' Desk Reference, 66th Edition, PDR Network; 2012Edition (Dec. 27, 2011), the contents of which are incorporated byreference in its entirety.

The active compositions of the present invention may include classicpharmaceutical preparations. Administration of these compositionsaccording to the present invention may be via any common route so longas the target tissue is available via that route. This includes oral,nasal, or buccal. Alternatively, administration may be by intradermal,subcutaneous, intramuscular, intraperitoneal or intravenous injection,or by direct injection into cancer tissue. The agents disclosed hereinmay also be administered by catheter systems. Such compositions wouldnormally be administered as pharmaceutically acceptable compositions asdescribed herein.

Upon formulation, solutions may be administered in a manner compatiblewith the dosage formulation and in such amount as is therapeuticallyeffective. The formulations may easily be administered in a variety ofdosage forms such as injectable solutions, drug release capsules and thelike. For parenteral administration in an aqueous solution, for example,the solution generally is suitably buffered and the liquid diluent firstrendered isotonic with, for example, sufficient saline or glucose. Suchaqueous solutions may be used, for example, for intravenous,intramuscular, subcutaneous and intraperitoneal administration.Preferably, sterile aqueous media are employed as is known to those ofskill in the art, particularly in light of the present disclosure.

Exemplary subjects or patients refers to any vertebrate including,without limitation, humans and other primates (e.g., chimpanzees andother apes and monkey species), farm animals (e.g., cattle, sheep, pigs,goats, and horses), domestic mammals (e.g., dogs and cats), laboratoryanimals (e.g., rodents such as mice, rats, and guinea pigs), and birds(e.g., domestic, wild and game birds such as chickens, turkeys and othergallinaceous birds, ducks, geese, and the like). In some embodiments,the subject is a mammal. In some embodiments, the subject is a human.

Administration of the compositions described herein may be, for example,by injection, topical administration, ophthalmic administration andintranasal administration. The injection may include injections such as,but not limited to, intradermal, subcutaneous and intramuscular. Theinjection, in some embodiments, may be linked to an electrical force(e.g. electroporation, including with devices that find use inelectrochemotherapy (e.g. CLINIPORATOR, IGEA Srl, Carpi [MO], Italy)).The topical administration may be, but is not limited to, a cream,lotion, ointment, gel, spray, solution and the like. The topicaladministration may further include a penetration enhancer such as, butnot limited to, surfactants, fatty acids, bile salts, chelating agents,non-chelating non-surfactants, polyoxyethylene-9-lauryl ether,polyoxyethylene-20-cetyl ether, fatty acids and/or salts in combinationwith bile acids and/or salts, sodium salt in combination with lauricacid, capric acid and UDCA, and the like. The topical administration mayalso include a fragrance, a colorant, a sunscreen, an antibacterialand/or a moisturizer. The compositions described herein may beadministered to at least one site such as, but not limited to, forehead,scalp, hair follicles, hair, upper eyelids, lower eyelids, eyebrows,eyelashes, infraorbital area, periorbital areas, temple, nose, nosebridge, cheeks, tongue, nasolabial folds, lips, periobicular areas, jawline, ears, neck, breast, forearm, upper arm, palm, hand, finger, nails,back, abdomen, sides, buttocks, thigh, calf, feet, toes and the like.

Sequences SEQ ID NO Description 1 StsI 2 StsI-HA 3 StsI-HA2 4 StsI-UHA 5StsI-UHA2 6 StsI-HF 7 StsI-UHF 8 Oct4 9 Sox2 10 Klf4 11 c-Myc 12BIRC5_exon1 13 BIRC5_exon2 14 BIRC5_exon3 15 BIRC5_exon4 16 BIRC5-1.1-L17 BIRC5-1.1-R 18 BIRC5-1.2-L 19 BIRC5-1.2-R 20 BIRC5-1.3-L 21BIRC5-1.3-R 22 BIRC5-2.1-L 23 BIRC5-2.1-R 24 BIRC5-2.2-L 25 BIRC5-2.2-R26 BIRC5-3.1-L 27 BIRC5-3.1-R 28 CDK1 29 CDK2 30 CDK3 31 CDK4 32 CDK5 33CDK6 34 BIRC5 35 HIF1A 36 RRM2 37 KRAS 38 EGFR 39 MYC 40 PKN3 41 KIF1142 APC 43 BRCA1 44 BRCA2 45 TP53 46 APP 47 HTT 48 IAPP 49 MAPT 50 PRNP51 SNCA 52 SOD1 53 FokI 54 Repeat1 55 Repeat2 56 Repeat3 57 EO-GHGG-FokI58 GHGG-FokI 59 EO-GHGG-StsI 60 GHGG-StsI 61 collagen alpha-1(I) chainpreproprotein 62 collagen alpha-2(I) chain precursor 63 collagenalpha-1(II) chain isoform 1 precursor 64 collagen alpha-1(II) chainisoform 2 precursor 65 collagen alpha-1(III) chain preproprotein 66collagen alpha-1(IV) chain preproprotein 67 collagen alpha-2(IV) chainpreproprotein 68 collagen alpha-3(IV) chain precursor 69 collagenalpha-4(IV) chain precursor 70 collagen alpha-5(IV) chain isoform 1precursor 71 collagen alpha-6(IV) chain isoform A precursor 72 collagenalpha-1(V) chain isoform 1 preproprotein 73 collagen alpha-2(V) chainpreproprotein 74 collagen alpha-3(V) chain preproprotein 75 collagenalpha-1(VI) chain precursor 76 collagen alpha-2(VI) chain isoform 2C2precursor 77 collagen alpha-3(VI) chain isoform 1 precursor 78 collagenalpha-1(VII) chain precursor 79 elastin isoform a precursor 80 elastinisoform b precursor 81 elastin isoform c precursor 82 elastin isoform dprecursor 83 elastin isoform e precursor 84 elastin isoform f precursor85 elastin isoform g precursor 86 elastin isoform h precursor 87 elastinisoform i precursor 88 elastin isoform j precursor 89 elastin isoform kprecursor 90 elastin isoform l precursor 91 elastin isoform m precursor92 protein-lysine 6-oxidase isoform 1 preproprotein 93 protein-lysine6-oxidase isoform 2 94 telomerase reverse transcriptase isoform 1 95telomerase reverse transcriptase isoform 2 96 fibronectin isoform 1preproprotein 97 fibronectin isoform 3 preproprotein 98 fibronectinisoform 4 preproprotein 99 fibronectin isoform 5 preproprotein 100fibronectin isoform 6 preproprotein 101 fibronectin isoform 7preproprotein 102 vitronectin precursor 103 nidogen-1 precursor 104laminin subunit alpha-1 precursor 105 insulin-like growth factor Iisoform 1 preproprotein 106 fibroblast growth factor 1 isoform 1precursor 107 fibroblast growth factor 2 108 transforming growth factorbeta-1 precursor 109 transforming growth factor beta-2 isoform 1precursor 110 transforming growth factor beta-2 isoform 2 precursor 111actin, alpha skeletal muscle 112 actin, aortic smooth muscle 113 actin,cytoplasmic 1 114 actin, alpha cardiac muscle 1 proprotein 115 actin,cytoplasmic 2 116 actin, gamma-enteric smooth muscle isoform 1 precursor117 actin, gamma-enteric smooth muscle isoform 2 precursor 118granulocyte colony-stimulating factor isoform a precursor 119granulocyte colony-stimulating factor isoform b precursor 120granulocyte colony-stimulating factor isoform c precursor 121granulocyte colony-stimulating factor isoform d precursor 122platelet-derived growth factor subunit A isoform 1 preproprotein 123platelet-derived growth factor subunit A isoform 2 preproprotein 124platelet-derived growth factor subunit B isoform 1 preproprotein 125platelet-derived growth factor subunit B isoform 2 preproprotein 126platelet-derived growth factor C precursor 127 platelet-derived growthfactor D isoform 1 precursor 128 platelet-derived growth factor Disoform 2 precursor 129 interstitial collagenase isoform 1 preproprotein130 interstitial collagenase isoform 2 131 neutrophil collagenasepreproprotein 132 stromelysin-2 preproprotein 133 macrophagemetalloelastase preproprotein 134 fibrillin-1 precursor 135 fibrillin-2precursor 136 lysyl oxidase homolog 1 preproprotein 137 lysyl oxidasehomolog 2 precursor 138 lysyl oxidase homolog 3 isoform 1 precursor 139lysyl oxidase homolog 3 isoform 2 precursor 140 lysyl oxidase homolog 3isoform 3 141 lysyl oxidase homolog 4 precursor 142microfibrillar-associated protein 2 isoform a precursor 143microfibrillar-associated protein 2 isoform b precursor 144microfibrillar-associated protein 5 precursor 145 disintegrin andmetalloproteinase domain-containing protein 17 preprotein 146desmoglein-2 preproprotein 147 DNA polymerase eta isoform 1 148 DNApolymerase eta isoform 2 149 DNA polymerase eta isoform 3 150ferrochelatase, mitochondrial isoform a precursor 151 ferrochelatase,mitochondrial isoform b precursor 152 filaggrin 153 hyaluronan synthase1 isoform 1 154 hyaluronan synthase 1 isoform 2 155 hyaluronan synthase2 156 hyaluronan synthase 3 isoform a 157 hyaluronan synthase 3 isoformb 158 proopiomelanocortin 159 plakophilin-1 isoform 1a 160 plakophilin-1isoform 1b 161 retinol dehydrogenase 10 162 mitochondrial brown fatuncoupling protein 1 163 tyrosinase precursor

This invention is further illustrated by the following non-limitingexamples.

EXAMPLES Example 1 RNA Synthesis

RNA encoding green fluorescent protein or the human proteins Elastin,Tyrosinase, Melanocortin 1 receptor, Hyaluronan synthase 1, Hyaluronansynthase 2, Hyaluronan synthase 3, Collagen type III al, Collagen typeVII al, Interleukin 10, P-selectin glycoprotein ligand-1,Alpha-(1,3)-fucosyltransferase Oct4, Sox2, Klf4, c-Myc-2 (T58A), andLin28 or TALENs targeting the human genes XPA, CCR5, TERT, MYC, andBIRC5, and comprising various combinations of canonical andnon-canonical nucleotides, was synthesized from DNA templates using theT7 High Yield RNA Synthesis Kit and the Vaccinia Capping System kit withmRNA Cap 2′-O-Methyltransferase (all from New England Biolabs, Inc.),according to the manufacturer's instructions and the present inventors'previously disclosed inventions (U.S. application Ser. No. 13/465,490(now U.S. Pat. No. 8,497,124), International Application No.PCT/US12/67966, U.S. application Ser. No. 13/931,251, and InternationalApplication No. PCT/US13/68118, the contents of all of which are herebyincorporated by reference in their entirety) (Table 4). The RNA was thendiluted with nuclease-free water to between 100 ng/μL and 1000 ng/μL.For certain experiments, an RNase inhibitor (Superase•In, LifeTechnologies Corporation) was added at a concentration of 1 μL/100 μg ofRNA. RNA solutions were stored at 4C. For reprogramming experiments, RNAencoding Oct4, Sox2, Klf4, c-Myc-2 (T58A), and Lin28 was mixed at amolar ratio of 3:1:1:1:1.

TABLE 4 RNA Synthesis Reaction ivT Template Nucleotides Volume/μLYield/μg hELN A, 0.5 7dG, 0.4 5mU, 20 34.1 5mC Oct4 A, 0.57 dG, 0.4 5mU,300 2752.0 (SEQ ID NO: 8) 5mC Sox2 A, 0.5 7dG, 0.4 5mU, 100 965.0 (SEQID NO: 9) 5mC Klf4 A, 0.5 7dG, 0.4 5mU, 100 1093.8 (SEQ ID NO: 10) 5mCc-Myc-2 (T58A) A, 0.5 7dG, 0.4 5mU, 100 1265.6 5mC Lin28 A, 0.5 7dG, 0.45mU, 100 1197.8 5mC ELN A, G, U, 5hmC 20 67.6 GFP A, 0.5 7dG, 0.4 5mU,10 60.5 5mC GFP A, 0.5 7dG, 0.4 5mU, 10 25.5 5hmC GFP A, G, U, 5hmC 1058.3 GFP A, 0.5 7dG, U, 5hmC 10 47.3 GFP A, 0.5 7dG, 0.4 5mU, 10 33.85cC GFP A, G, U, 5hmC 15 30.3 GFP A, G, U, 5hmC 15 44.6 GFP A, G, U,5hmC 15 24.7 TYR A, G, U, 5hmC 15 45.4 MC1R A, G, U, 5hmC 15 47.5 TYR A,G, U, C 20 67.0 TYR A, G, psU, C 20 93.7 TYR A, G, 5mU, C 20 85.7 TYR A,G, U, 5mC 20 73.4 TYR A, G, U, 5hmC 20 72.7 TYR A, 0.5 7dG, U, C 20 62.7TYR A, G, psU, 5mC 20 116.3 TYR A, G, psU, 5hmC 20 102.4 TYR A, 0.5 7dG,psU, C 20 87.3 TYR A, G, 0.4 5mU, 5mC 20 106.5 TYR A, G, 0.4 5mU, 5hmC20 85.0 TYR A, 0.5 7dG, 0.4 5mU, 20 70.9 C TYR A, 0.5 7dG, U, 5mC 2088.5 TYR A, 0.5 7dG, U, 5hmC 20 59.1 TYR A, 0.5 7dG, psU, 5mC 20 7.8 TYRA, 0.5 7dG, psU, 5hmC 20 98.0 TYR A, 0.5 7dG, 0.4 5mU, 20 106.5 5mC TYRA, 0.5 7dG, 0.4 5mU, 20 82.3 5hmC HAS1 A, G, 0.4 5mU, 5hmC 20 178.4 HAS2A, G, 0.4 5mU, 5hmC 20 59.3 HAS3 A, G, 0.4 5mU, 5hmC 20 102.6 TYR A, G,0.4 5mU, 5hmC 100 377.3 COL3A1 A, G, 0.4 5mU, 5hmC 20 108.3 COL7A1 A, G,0.4 5mU, 5hmC 20 94.6 IL10 A, G, psU, C 75 569.5 SELPLG A, G, psU, C 75542.6 FUT7 A, G, psU, C 75 564.5 Oct4 A, G, U, C 10 100.7 (SEQ ID NO: 8)Oct4 A, G, U, 5mC 10 120.6 (SEQ ID NO: 8) Oct4 A, G, U, 5mC 10 115.3(SEQ ID NO: 8) Oct4 A, G, U, 5hmC 10 101.4 (SEQ ID NO: 8) Oct4 A, G, U,5cC 10 50.8 (SEQ ID NO: 8) Oct4 A, G, U, 5fC 10 84.0 (SEQ ID NO: 8) Oct4A, G, U, 5hmC 10 99.5 (SEQ ID NO: 8) Sox2 A, G, U, 5hmC 10 84.0 (SEQ IDNO: 9) Klf4 A, G, U, 5hmC 10 72.6 (SEQ ID NO: 10) c-Myc-2 (T58A) A, G,U, 5hmC 10 82.4 Lin28 A, G, U, 5hmC 10 83.1 Oct4 A, G, 0.4 5mU, 5hmC 1078.9 (SEQ ID NO: 8) Sox2 A, G, 0.4 5mU, 5hmC 10 91.9 (SEQ ID NO: 9) Klf4A, G, 0.4 5mU, 5hmC 10 91.2 (SEQ ID NO: 10) c-Myc-2 (T58A) A, G, 0.45mU, 5hmC 10 104.6 Lin28 A, G, 0.4 5mU, 5hmC 10 103.2 Oct4 A, G, 5hU,5hmC 300 1925.5 (SEQ ID NO: 8) Sox2 A, G, 5hU, 5hmC 100 641.8 (SEQ IDNO: 9) Klf4 A, G, 5hU, 5hmC 100 739.0 (SEQ ID NO: 10) c-Myc-2 (T58A) A,G, 5hU, 5hmC 100 574.0 Lin28 A, G, 5hU, 5hmC 100 556.0 “A” refers toadenosine-5′-triphosphate, “G” refers to guanosine-5′-triphosphate, “U”refers to uridine-5′-triphosphate, “C” refers tocytidine-5′-triphosphate, “5mC” refers to5-methylcytidine-5′-triphosphate, “5hmC” refers to5-hydroxymethylcytidine-5′-triphosphate, “5cC” refers to5-carboxycytidine-5′-triphosphate, “5fC” refers to5-formylcytidine-5′-triphosphate, “psU” refers to5-pseudouridine-5′-triphosphate, “5mU” refers to5-methyluridine-5′-triphosphate, “5hU” refers to the 5′-triphosphate ofuridine with a methyl group bound to an oxygen atom bound to the 5Cposition of the uridine, and “7dG” refers to7-deazaguanosine-5′-triphosphate.

Example 2 Transfection of Cells with Synthetic RNA

For transfection in 6-well plates, 2 μg RNA and 6 μL transfectionreagent (Lipofectamine RNAiMAX, Life Technologies Corporation) werefirst diluted separately in complexation medium (Opti-MEM, LifeTechnologies Corporation or DMEM/F12+10 μg/mL insulin+5.5 μg/mLtransferrin+6.7 ng/mL sodium selenite+2 μg/mL ethanolamine) to a totalvolume of 60 μL each. Diluted RNA and transfection reagent were thenmixed and incubated for 15 min at room temperature, according to thetransfection reagent-manufacturer's instructions. Complexes were thenadded to cells in culture. Between 12 μL and 240 μL of complexes wereadded to each well of a 6-well plate, which already contained 2 mL oftransfection medium per well. Plates were shaken gently to distributethe complexes throughout the well. Cells were incubated with complexesfor 4 hours to overnight, before replacing the medium with freshtransfection medium (2 mL/well). Volumes were scaled for transfection in24-well and 96-well plates. Alternatively, between 0.5 μg and 5 μg ofRNA and between 2-3 μL of transfection reagent (Lipofectamine 2000, LifeTechnologies Corporation) per μg of RNA were first diluted separately incomplexation medium (Opti-MEM, Life Technologies Corporation orDMEM/F12+10 μg/mL insulin+5.5 μg/mL transferrin+6.7 ng/mL sodiumselenite+2 μg/mL ethanolamine) to a total volume of between 5 μL and 100μL each. Diluted RNA and transfection reagent were then mixed andincubated for 10 min at room temperature. Complexes were then added tocells in culture. Between 10 μL and 200 μL of complexes were added toeach well of a 6-well plate, which already contained 2 mL oftransfection medium per well. In certain experiments, DMEM+10% FBS orDMEM+50% FBS was used in place of transfection medium. Plates wereshaken gently to distribute the complexes throughout the well. Cellswere incubated with complexes for 4 hours to overnight. In certainexperiments, the medium was replaced with fresh transfection medium (2mL/well) 4 h or 24 h after transfection.

Example 3 Toxicity of and Protein Translation from Synthetic RNAContaining Non-Canonical Nucleotides

Primary human fibroblasts were transfected according to Example 2, usingRNA synthesized according to Example 1. Cells were fixed and stained20-24 h after transfection using an antibody against Oct4. The relativetoxicity of the RNA was determined by assessing cell density at the timeof fixation.

Example 4 Transfection Medium Formulation

A cell-culture medium was developed to support efficient transfection ofcells with nucleic acids and efficient reprogramming (“transfectionmedium”):

DMEM/F12+15 mM HEPES+2 mM L-alanyl-L-glutamine+10 μg/mL insulin+5.5μg/mL transferrin+6.7 ng/mL sodium selenite+2 μg/mL ethanolamine+50μg/mL L-ascorbic acid 2-phosphate sesquimagnesium salt hydrate+4 μg/mLcholesterol+1 μM hydrocortisone+25 μg/mL polyoxyethylenesorbitanmonooleate+2 μg/mL D-alpha-tocopherol acetate+20 ng/mL bFGF+5 mg/mLtreated human serum albumin.

A variant of this medium was developed to support robust, long-termculture of a variety of cell types, including pluripotent stem cells(“maintenance medium”):

DMEM/F12+2 mM L-alanyl-L-glutamine+10 μg/mL insulin+5.5 μg/mLtransferrin+6.7 ng/mL sodium selenite+2 μg/mL ethanolamine+50 μg/mLL-ascorbic acid 2-phosphate sesquimagnesium salt hydrate+20 ng/mL bFGF+2ng/mL TGF-31.

Transfection medium, in which the treated human serum albumin wastreated by addition of 32 mM sodium octanoate, followed by heating at60C for 4 h, followed by treatment with ion-exchange resin (AG501-X8(D),Bio-Rad Laboratories, Inc.) for 6 h at room temperature, followed bytreatment with dextran-coated activated charcoal (C6241, Sigma-AldrichCo. LLC.) overnight at room temperature, followed by centrifugation,filtering, adjustment to a 10% solution with nuclease-free water,followed by addition to the other components of the medium, was used asthe transfection medium in all Examples described herein, unlessotherwise noted. For reprogramming experiments, cells were plated eitheron uncoated plates in DMEM+10%-20% serum or on fibronectin andvitronectin-coated plates in transfection medium, unless otherwisenoted. The transfection medium was not conditioned, unless otherwisenoted. It is recognized that the formulation of the transfection mediumcan be adjusted to meet the needs of the specific cell types beingcultured. It is further recognized that treated human serum albumin canbe replaced with other treated albumin, for example, treated bovineserum albumin, without negatively affecting the performance of themedium. It is further recognized that other glutamine sources can beused instead of or in addition to L-alanyl-L-glutamine, for example,L-glutamine, that other buffering systems can be used instead of or inaddition to HEPES, for example, phosphate, bicarbonate, etc., thatselenium can be provided in other forms instead of or in addition tosodium selenite, for example, selenous acid, that other antioxidants canbe used instead of or in addition to L-ascorbic acid 2-phosphatesesquimagnesium salt hydrate and/or D-alpha-tocopherol acetate, forexample, L-ascorbic acid, that other surfactants can be used instead ofor in addition to polyoxyethylenesorbitan monooleate, for example,Pluronic F-68 and/or Pluronic F-127, that other basal media can be usedinstead of or in addition to DMEM/F12, for example, MEM, DMEM, etc., andthat the components of the culture medium can be varied with time, forexample, by using a medium without TGF-β from day 0 to day 5, and thenusing a medium containing 2 ng/mL TGF-β after day 5, without negativelyaffecting the performance of the medium. It is further recognized thatother ingredients can be added, for example, fatty acids,lysophosphatidic acid, lysosphingomyelin, sphingosine-1-phosphate, othersphingolipids, ROCK inhibitors, including Y-27632 and thiazovivin,members of the TGF-β/NODAL family of proteins, IL-6, members of the Wntfamily of proteins, etc., at appropriate concentrations, withoutnegatively affecting the performance of the medium, and that ingredientsthat are known to promote or inhibit the growth of specific cell typesand/or agonists and/or antagonists of proteins or other molecules thatare known to promote or inhibit the growth of specific cell types can beadded to the medium at appropriate concentrations when it is used withthose cell types without negatively affecting the performance of themedium, for example, sphingosine-1-phosphate and pluripotent stem cells.The present invention relates equally to ingredients that are added aspurified compounds, to ingredients that are added as parts ofwell-defined mixtures, to ingredients that are added as parts of complexor undefined mixtures, for example, animal or plant oils, and toingredients that are added by biological processes, for example,conditioning. The concentrations of the components can be varied fromthe listed values within ranges that will be obvious to persons skilledin the art without negatively affecting the performance of the medium.An animal component-free version of the medium was produced by usingrecombinant versions of all protein ingredients, and non-animal-derivedversions of all other components, including semi-synthetic plant-derivedcholesterol (Avanti Polar Lipids, Inc.).

Example 5 Transfection Medium Formulation

A medium was developed to support efficient transfection, reprogramming,and gene-editing of cells:

DMEM/F12+10 μg/mL insulin+5.5 μg/mL transferrin+6.7 ng/mL sodiumselenite+20 ng/mL bFGF+5 mg/mL treated human serum albumin.

Variants of this medium were also developed to provide improvedperformance when used with specific transfection reagents, specificnucleic acids, and specific cell types: DMEM/F12+10 μg/mL insulin+5.5μg/mL transferrin+6.7 ng/mL sodium selenite+4.5 μg/mL cholesterol+20ng/mL bFGF+5 mg/mL treated human serum albumin, DMEM/F12+10 μg/mLinsulin+5.5 μg/mL transferrin+6.7 ng/mL sodium selenite+1 μMhydrocortisone+20 ng/mL bFGF+5 mg/mL treated human serum albumin, andDMEM/F12+10 μg/mL insulin+5.5 μg/mL transferrin+6.7 ng/mL sodiumselenite+4.5 μg/mL cholesterol+1 μM hydrocortisone+20 ng/mL bFGF+5 mg/mLtreated human serum albumin.

Examples of additional components that were added to the cell-culturemedium in certain experiments (listed with example concentrations)include: 15 mM HEPES, 2 mM L-alanyl-L-glutamine, 2 μg/mL ethanolamine,10 μg/mL fatty acids, 10 μg/mL cod liver oil fatty acids (methylesters), 25 μg/mL polyoxyethylenesorbitan monooleate, 2 μg/mLD-alpha-tocopherol acetate, 1-50 μg/mL L-ascorbic acid 2-phosphatesesquimagnesium salt hydrate, 200 ng/mL B18R, and 0.1% Pluronic F-68.

For certain experiments in which the medium was conditioned, thefollowing variant was used:

DMEM/F12+15 mM HEPES+2 mM L-alanyl-L-glutamine+10 μg/mL insulin+5.5μg/mL transferrin+6.7 ng/mL sodium selenite+2 μg/mL ethanolamine+4.5μg/mL cholesterol+10 μg/mL cod liver oil fatty acids (methyl esters)+25μg/mL polyoxyethylenesorbitan monooleate+2 μg/mL D-alpha-tocopherolacetate+1 μg/mL L-ascorbic acid 2-phosphate sesquimagnesium salthydrate+0.1% Pluronic F-68+20 ng/mL bFGF+5 mg/mL treated human serumalbumin.

For certain experiments in which the medium was not conditioned, thefollowing variant was used.

DMEM/F12+15 mM HEPES+2 mM L-alanyl-L-glutamine+10 μg/mL insulin+5.5μg/mL transferrin+6.7 ng/mL sodium selenite+2 μg/mL ethanolamine+4.5μg/mL cholesterol+1 μM hydrocortisone+0-25 μg/mL polyoxyethylenesorbitanmonooleate+2 μg/mL D-alpha-tocopherol acetate+50 μg/mL L-ascorbic acid2-phosphate sesquimagnesium salt hydrate+20 ng/mL bFGF+5 mg/mL treatedhuman serum albumin.

For the preparation of the these variants, the treated human serumalbumin was treated by addition of 32 mM sodium octanoate, followed byheating at 60C for 4 h, followed by treatment with ion-exchange resin(AG501-X8(D)) for 6 h at room temperature, followed by treatment withdextran-coated activated charcoal (C6241, Sigma-Aldrich Co. LLC.)overnight at room temperature, followed by centrifugation, filtering,adjustment to a 10% solution with nuclease-free water, followed byaddition to the other components of the medium. For certain experimentsin which the medium was conditioned, the medium was conditioned for 24 hon irradiated human neonatal fibroblast feeders. The cells were platedon fibronectin-coated plates or fibronectin and vitronectin-coatedplates, unless otherwise noted.

The formulation of the medium can be adjusted to meet the needs of thespecific cell types being cultured. Furthermore, in certain situations,treated human serum albumin can be replaced with other treated albumin,for example, treated bovine serum albumin, other glutamine sources canbe used instead of or in addition to L-alanyl-L-glutamine, for example,L-glutamine, other buffering systems can be used instead of or inaddition to HEPES, for example, phosphate, bicarbonate, etc., seleniumcan be provided in other forms instead of or in addition to sodiumselenite, for example, selenous acid, other antioxidants can be usedinstead of or in addition to L-ascorbic acid 2-phosphate sesquimagnesiumsalt hydrate and/or D-alpha-tocopherol acetate, for example, L-ascorbicacid, other surfactants can be used instead of or in addition topolyoxyethylenesorbitan monooleate and/or Pluronic F-68, for example,Pluronic F-127, other basal media can be used instead of or in additionto DMEM/F12, for example, MEM, DMEM, etc., and the components of theculture medium can be varied with time, for example, by using a mediumwithout TGF-β from day 0 to day 5, and then using a medium containing 2ng/mL TGF-β after day 5. In certain situations, other ingredients can beadded, for example, fatty acids, lysophosphatidic acid,lysosphingomyelin, sphingosine-1-phosphate, other sphingolipids, membersof the TGF-β/NODAL family of proteins, IL-6, members of the Wnt familyof proteins, etc., at appropriate concentrations, and ingredients thatare known to promote or inhibit the growth of specific cell types and/oragonists and/or antagonists of proteins or other molecules that areknown to promote or inhibit the growth of specific cell types can beadded to the medium at appropriate concentrations when it is used withthose cell types, for example, sphingosine-1-phosphate and pluripotentstem cells. Ingredients can take the form of purified compounds, partsof well-defined mixtures, parts of complex or undefined mixtures, forexample, animal or plant oils, and may be added by biological processes,for example, conditioning. The concentrations of the components can bevaried from the listed values within ranges that will be obvious topersons skilled in the art.

Example 6 Transfection of Cells with Synthetic RNA

For transfection in 6-well plates, 2 μg RNA and 6 μL transfectionreagent (Lipofectamine™ RNAiMAX, Life Technologies Corporation) werefirst diluted separately in complexation medium (Opti-MEM®, LifeTechnologies Corporation) to a total volume of 60 μL each. Diluted RNAand transfection reagent were then mixed and incubated for 15 min atroom temperature, according to the transfection reagent-manufacturer'sinstructions. Complexes were then added to cells in culture. Between 30μL and 240 μL of complexes were added to each well of a 6-well plate,which already contained 2 mL of transfection medium per well. Plateswere then shaken gently to distribute the complexes throughout the well.Cells were incubated with complexes for 2 hours to overnight, beforereplacing the medium with fresh transfection medium (2 mL/well). Volumeswere scaled for transfection in 24-well and 96-well plates. Cells werefixed and stained 20-24 h after transfection using an antibody againstOct4. Nuclei were stained and counted to determine the relative toxicityof the RNA.

Example 7 Analysis of the Ability of Untreated Human Serum AlbuminPreparations to Support Nucleic Acid Transfection and RNA Reprogramming

Primary human neonatal fibroblasts were cultured in medium with orwithout 5 mg/mL HSA. Cohn Fraction V (A6784, Sigma-Aldrich Co. LLC.),and four different recombinant HSA preparations (A6608, A7736, A9731,and A9986, all from Sigma-Aldrich Co. LLC.) were screened. Cells weretransfected according to Example 2, with RNA synthesized according toExample 1. While untransfected cells grew well in media containing anyof the HSA preparations, in transfected wells, each of the HSApreparations yielded dramatically different cell morphologies and celldensities, and none resulted in morphological changes indicative ofreprogramming.

Example 8 Production of Octanoate-Treated Human Serum Albumin

A 10% solution of HSA was pre-incubated with 22 mM sodium chloride and16 mM sodium octanoate (Sigma-Aldrich Co. LLC), and was incubated at 37C for 3 hours before assembly of the complete medium.

Example 9 Treatment of Human Serum Albumin Using Ion-ExchangeChromatography

A 20% solution of recombinant HSA produced in Pichia pastoris (A7736,Sigma-Aldrich Co. LLC.) was prepared by dissolving 2 g of HSA in 10 mLof nuclease-free water with gentle agitation at room temperature. TheHSA solution was then deionized by first adding 1 g of mixed-beddeionizing resin (AG 501-X8(D), Bio-Rad Laboratories, Inc.), and rockingfor 1 h at room temperature. The HSA solution was then decanted into atube containing 5 g of fresh resin, and was rocked for 4 h at roomtemperature. Finally, the deionized HSA solution was decanted, adjustedto a 10% total protein content with nuclease-free water,filter-sterilized using a 0.2 μm PES-membrane filter, and stored at 4 C.

Example 10 Analysis of Transfection Efficiency and Viability of CellsCultured in Media Containing Octanoate-Treated Human Serum Albumin

Primary human neonatal fibroblasts were cultured in media containingrecombinant HSA treated according to Example 8 and/or Example 9 orcontaining treated blood-derived HSA (Bio-Pure HSA, BiologicalIndustries). Cells were transfected daily, according to Example 2, withRNA synthesized according to Example 1, beginning on day 0. Pictureswere taken on day 3. Several small areas of cells undergoingmorphological changes resembling mesenchymal to epithelial transitionwere observed in the wells containing octanoate, indicating an increasedtransfection efficiency. Many large areas of morphological changesresembling mesenchymal to epithelial transition were observed in thesamples containing the treated blood-derived HSA. In both cases, themorphological changes were characteristic of reprogramming.

Example 11 Reprogramming Human Fibroblasts Using Media ContainingOctanoate-Treated Human Serum Albumin

Primary human neonatal fibroblasts were plated in 6-well plates at adensity of 5000 cells/well in fibroblast medium (DMEM+10% fetal bovineserum). After 6 hours, the medium was replaced with transfection mediumcontaining octanoate-treated HSA. The cells were transfected daily,according to Example 2, with RNA synthesized according to Example 1,beginning on day 0. By day 5, the well contained several areas of cellsexhibiting morphology consistent with reprogramming. This experiment didnot include the use of feeders or immunosuppressants.

Example 12 Analysis of Transfection Efficiency and Viability of CellsCultured in Media Containing Ion-Exchange-Resin-Treated Human SerumAlbumin

Primary human neonatal fibroblasts were transfected according to Example2, with RNA synthesized according to Example 1, beginning on day 0.Pictures were taken on day 2. Cells in the well containing untreated HSAexhibited low viability compared to either the well containing treatedblood-derived HSA or ion-exchange-resin-treated recombinant HSA.

Example 13 Reprogramming Human Fibroblasts UsingIon-Exchange-Resin-Treated Human Serum Albumin

Primary human neonatal fibroblasts were plated in 6-well plates onfeeders at a density of 10,000 cells/well in fibroblast medium (DMEM+10%fetal bovine serum). The cells were transfected daily according toExample 2, with RNA synthesized according to Example 1, beginning on day0. A passage with a split ratio of 1:20 was performed on day 4. Pictureswere taken on day 10. The well contained many large colonies of cellsexhibiting morphology consistent with reprogramming. No colonies wereobserved in wells exposed to cell-culture media containing untreatedHSA.

Example 14 Reprogramming Human Fibroblasts without Using Feeders orImmunosuppressants

Primary human fibroblasts were plated in 6-well plates at a density of20,000 cells/well in fibroblast medium (DMEM+10% fetal bovine serum).After 6 hours, the medium was replaced with transfection mediumcontaining treated HSA and not containing immunosuppressants, and thecells were transfected daily according to Example 2, with RNAsynthesized according to Example 1, except that the dose of RNA wasreduced to 1 μg/well and a total of 5 transfections were performed.Pictures were taken on day 7. Small colonies of cells exhibitingmorphology consistent with reprogramming became visible as early as day5. On day 7, the medium was replaced with DMEM/F12+20% Knockout™ SerumReplacement (Life Technologies Corporation)+1× non-essential aminoacids+2 mM L-glutamine, conditioned on irradiated mouse embryonicfibroblasts for 24 hours, and then supplemented with 20 ng/mL bFGF and10 μM Y-27632. Large colonies with a reprogrammed morphology becamevisible as early as day 8. Colonies were picked on day 10, and plated inwells coated with basement membrane extract (Cultrex® Human BMEPathclear®, Trevigen Inc.). Cells grew rapidly, and were passaged toestablish lines. Established lines stained positive for the pluripotentstem-cell markers Oct4 and SSEA4. The entire protocol was repeated, andsimilar results were obtained.

Example 15 Efficient, Rapid Derivation and Reprogramming of Cells fromHuman Skin Biopsy Tissue

A full-thickness dermal punch biopsy was performed on a healthy, 31year-old volunteer, according to an approved protocol. Briefly, an areaof skin on the left, upper arm was anesthetized by topical applicationof 2.5% lidocaine. The field was disinfected with 70% isopropanol, and afull-thickness dermal biopsy was performed using a 1.5 mm-diameterpunch. The tissue was rinsed in phosphate-buffered saline (PBS), and wasplaced in a 1.5 mL tube containing 250 μL of TrypLE™ Select CTS™ (LifeTechnologies Corporation), and incubated at 37 C for 30 min. The tissuewas then transferred to a 1.5 mL tube containing 250 μL of DMEM/F12-CTS™(Life Technologies Corporation)+5 mg/mL collagenase, and incubated at 37C for 2 h. The epidermis was removed using forceps, and the tissue wasmechanically dissociated. Cells were rinsed twice in DMEM/F12-CTS™ andwere plated in fibronectin-coated wells of 24-well and 96-well plates.Phlebotomy was also performed on the same volunteer, and venous bloodwas collected in Vacutainer® SST™ tubes (Becton, Dickinson and Company).Serum was isolated according to the manufacturer's protocol. Isogenicplating medium was prepared by mixing DMEM/F12-CTS™+2 mML-alanyl-L-glutamine (Sigma-Aldrich Co. LLC.)+20% human serum. Cellsfrom the dermal tissue sample were plated either in transfection mediumor in isogenic plating medium. After 2 days, the wells were rinsed, andthe medium was replaced with transfection medium. Many cells with afibroblast morphology attached and began to spread by day 2. Cells weretransfected according to Example 2, with RNA synthesized according toExample 1, beginning on day 2, with all volumes scaled to accommodatethe smaller wells. By day 5, areas of cells with morphologies consistentwith reprogramming were observed.

Example 16 Reprogramming Human Fibroblasts Using Synthetic RNAContaining Non-Canonical Nucleotides

Primary human fibroblasts were plated in 6-well plates coated withrecombinant human fibronectin and recombinant human vitronectin (eachdiluted in DMEM/F12 to a concentration of 1 μg/mL, 1 mL/well, incubatedat room temperature for 1 h) at a density of 20,000 cells/well intransfection medium. The following day, the cells were transfected as inExample 2, with RNA synthesized according to Example 1, except that thedose of RNA was 0.5 μg/well on day 1, 0.5 μg/well on day 2, and 2μg/well on day 3. Pictures were taken on day 4. Small colonies of cellsexhibiting morphology consistent with reprogramming were visible on day4.

Example 17 Reprogramming Human Fibroblasts with a Non-ConditionedTransfection Medium

Primary human fibroblasts were plated in 6-well plates coated withrecombinant human fibronectin and recombinant human vitronectin (eachdiluted in DMEM/F12 to a concentration of 1 μg/mL, 1 mL/well, incubatedat room temperature for 1 h) at a density of 20,000 cells/well intransfection medium. The following day, the cells were transfected as inExample 2, with RNA synthesized according to Example 1, except that thedose of RNA was 0.5 μg/well on day 1, 0.5 μg/well on day 2, 2 μg/well onday 3, 2 μg/well on day 4, and 4 μg/well on day 5. Small colonies ofcells exhibiting morphology consistent with reprogramming became visibleas early as day 5. On day 7, the medium was replaced with DMEM/F12+20%Knockout™ Serum Replacement (Life Technologies Corporation)+1×non-essential amino acids+2 mM L-glutamine, conditioned on irradiatedmouse embryonic fibroblasts for 24 hours, and then supplemented with 20ng/mL bFGF and 10 μM Y-27632. Large colonies with a reprogrammedmorphology became visible as early as day 8. Colonies were picked on day10, and plated in wells coated with basement membrane extract (Cultrex®Human BME Pathclear®, Trevigen Inc.). Cells grew rapidly, and werepassaged to establish lines.

Example 18 Reprogramming Human Fibroblasts Using Synthetic RNAContaining Non-Canonical Nucleotides

Primary human neonatal fibroblasts were plated in 6-well plates coatedwith recombinant human fibronectin and recombinant human vitronectin(each diluted in DMEM/F12 to a concentration of 1 μg/mL, 1 mL/well, andincubated at room temperature for 1 h) at a density of 10,000 cells/wellin transfection medium. The following day, the cells were transfected asin Example 2, using RNA containing A, 0.5 7 dG, 0.5 5 mU, and 5 mC, andan RNA dose of 0.5 μg/well on day 1, 0.5 μg/well on day 2, 2 μg/well onday 3, 2 μg/well on day 4, and 4 μg/well on day 5. Small colonies ofcells exhibiting morphology consistent with reprogramming became visibleas early as day 5. The medium was replaced with maintenance medium onday 6. Cells were stained using an antibody against Oct4. Oct4-positivecolonies of cells exhibiting a morphology consistent with reprogrammingwere visible throughout the well.

Example 19 Feeder-Free, Passage-Free, Immunosuppressant-Free,Conditioning-Free Reprograming of Primary Adult Human Fibroblasts UsingSynthetic RNA

Wells of a 6-well plate were coated with a mixture of recombinant humanfibronectin and recombinant human vitronectin (1 μg/mL in DMEM/F12, 1mL/well) for 1 h at room temperature. Primary adult human fibroblastswere plated in the coated wells in transfection medium at a density of10,000 cells/well. Cells were maintained at 37 C, 5% CO₂, and 5% 02.Beginning the following day, cells were transfected according to Example2 daily for 5 days with RNA synthesized according to Example 1. Thetotal amount of RNA transfected on each of the 5 days was 0.5 μg, 0.5μg, 2 μg, 2 μg, and 4 μg, respectively. Beginning with the fourthtransfection, the medium was replaced twice a day. On the day followingthe final transfection, the medium was replaced with transfectionmedium, supplemented with 10 μM Y-27632. Alternatively, the total amountof RNA transfected on each day was 0.25 μg, 0, 0.5 μg, 0.5 μg, and 0.5μg, respectively or 0.25 μg, 0, 0.25 μg, 0.25 μg, 0.25 μg, and 0.25 μg,respectively. In certain experiments, transfection medium was changedonly once per day, at the time of transfection. Compact colonies ofcells with a reprogrammed morphology were visible in each transfectedwell by day 4.

Example 20 Efficient, Rapid Derivation and Reprogramming of Cells fromAdult Human Skin Biopsy Tissue

A full-thickness dermal punch biopsy was performed on a healthy, 31year-old volunteer, according to an approved protocol. Briefly, an areaof skin on the left, upper arm was anesthetized by topical applicationof 2.5% lidocaine. The field was disinfected with 70% isopropanol, and afull-thickness dermal biopsy was performed using a 1.5 mm-diameterpunch. The tissue was rinsed in phosphate-buffered saline (PBS), wasplaced in a 1.5 mL tube containing 250 μL of TrypLE Select CTS (LifeTechnologies Corporation), and was incubated at 37 C for 30 min. Thetissue was then transferred to a 1.5 mL tube containing 250 μL ofDMEM/F12-CTS (Life Technologies Corporation)+5 mg/mL collagenase, andwas incubated at 37 C for 2 h. The epidermis was removed using forceps,and the tissue was mechanically dissociated. Cells were rinsed twice inDMEM/F12-CTS. Phlebotomy was also performed on the same volunteer, andvenous blood was collected in Vacutainer SST tubes (Becton, Dickinsonand Company). Serum was isolated according to the manufacturer'sinstructions. Isogenic plating medium was prepared by mixingDMEM/F12-CTS+2 mM L-alanyl-L-glutamine (Sigma-Aldrich Co. LLC.)+20%human serum. Cells from the dermal tissue sample were plated in afibronectin-coated well of a 6-well plate in isogenic plating medium.Many cells with a fibroblast morphology attached and began to spread byday 2. Cells were expanded and frozen in Synth-a-Freeze (LifeTechnologies Corporation).

Cells were passaged into 6-well plates at a density of 5,000 cells/well.The following day, the medium was replaced with transfection medium, andthe cells were transfected as in Example 2, using RNA containing A, 0.57 dG, 0.4 5 mU, and 5 mC, and an RNA dose of 0.5 μg/well on day 1, 0.5μg/well on day 2, 2 μg/well on day 3, 2 μg/well on day 4, and 2 μg/wellon day 5. Certain wells received additional 2 μg/well transfections onday 6 and day 7. In addition, certain wells received 2 ng/mL TGF-β1 fromday 4 onward. The medium was replaced with maintenance medium on day 6.Colonies of cells exhibiting morphology consistent with reprogrammingbecame visible between day 5 and day 10. Colonies grew rapidly, and manyexhibited a morphology similar to that of embryonic stem-cell colonies.Colonies were picked and plated in wells coated with recombinant humanfibronectin and recombinant human vitronectin (each diluted in DMEM/F12to a concentration of 1 μg/mL, 1 mL/well, incubated at room temperaturefor 1 h). Cells grew rapidly, and were passaged to establish lines.

Example 21 High-Efficiency Gene Editing by Repeated Transfection withRiboSlice

Primary human fibroblasts were plated as in Example 19. The followingday, the cells were transfected as in Example 2 with RNA synthesizedaccording to Example 1. The following day cells in one of the wells weretransfected a second time. Two days after the second transfection, theefficiency of gene editing was measured using a mutation-specificnuclease assay.

Example 22 Transfection of Cells with Synthetic RNA ContainingNon-Canonical Nucleotides and DNA Encoding a Repair Template

For transfection in 6-well plates, 1 μg RNA encoding gene-editingproteins targeting exon 16 of the human APP gene, 1 μg single-strandedrepair template DNA containing a Pstl restriction site that was notpresent in the target cells, and 6 μL transfection reagent(Lipofectamine RNAiMAX, Life Technologies Corporation) were firstdiluted separately in complexation medium (Opti-MEM, Life TechnologiesCorporation) to a total volume of 120 μL. Diluted RNA, repair template,and transfection reagent were then mixed and incubated for 15 min atroom temperature, according to the transfection reagent-manufacturer'sinstructions. Complexes were added to cells in culture. Approximately120 μL of complexes were added to each well of a 6-well plate, whichalready contained 2 mL of transfection medium per well. Plates wereshaken gently to distribute the complexes throughout the well. Cellswere incubated with complexes for 4 hours to overnight, before replacingthe medium with fresh transfection medium (2 mL/well). The next day, themedium was changed to DMEM+10% FBS. Two days after transfection, genomicDNA was isolated and purified. A region within the APP gene wasamplified by PCR, and the amplified product was digested with Pstl andanalyzed by gel electrophoresis.

Example 23 In Vivo RiboSlice Safety Study

40 female NCr nu/nu mice were injected subcutaneously with 5×10⁶MDA-MB-231 tumor cells in 50% Matrigel (BD Biosciences). Cell injectionvolume was 0.2 mL/mouse. The age of the mice at the start of the studywas 8 to 12 weeks. A pair match was conducted, and animals were dividedinto 4 groups of 10 animals each when the tumors reached an average sizeof 100-150 mm³, and treatment was begun. Body weight was measured everyday for the first 5 days, and then biweekly to the end of the study.Treatment consisted of RiboSlice BIRC5-1.2 complexed with a vehicle(Lipofectamine 2000, Life Technologies Corporation). To prepare thedosing solution for each group, 308 μL of complexation buffer (Opti-MEM,Life Technologies Corporation) was pipetted into each of two sterile,RNase-free 1.5 mL tubes. 22 μL of RiboSlice BIRC5-1.2 (500 ng/μL) wasadded to one of the two tubes, and the contents of the tube were mixedby pipetting. 22 μL of vehicle was added to the second tube. Thecontents of the second tube were mixed, and then transferred to thefirst tube, and mixed with the contents of the first tube by pipettingto form complexes. Complexes were incubated at room temperature for 10min. During the incubation, syringes were loaded. Animals were injectedeither intravenously or intratumorally with a total dose of 1 μgRNA/animal in 60 μL total volume/animal. A total of 5 treatments weregiven, with injections performed every other day. Doses were notadjusted for body weight. Animals were followed for 17 days. Nosignificant reduction in mean body weight was observed, demonstratingthe in vivo safety of RiboSlice gene-editing RNA.

Example 24 Screening of Reagents for Delivery of Nucleic Acids to Cells

Delivery reagents including polyethyleneimine (PEI), various commerciallipid-based transfection reagents, a peptide-based transfection reagent(N-TER, Sigma-Aldrich Co. LLC.), and several lipid-based andsterol-based delivery reagents were screened for transfection efficiencyand toxicity in vitro. Delivery reagents were complexed with RiboSliceBIRC5-1.2, and complexes were delivered to HeLa cells in culture.Toxicity was assessed by analyzing cell density 24 h after transfection.Transfection efficiency was assessed by analyzing morphological changes.The tested reagents exhibited a wide range of toxicities andtransfection efficiencies. Reagents containing a higher proportion ofester bonds exhibited lower toxicities than reagents containing a lowerproportion of ester bonds or no ester bonds.

Example 25 High-Concentration Liposomal RiboSlice

High-Concentration Liposomal RiboSlice was prepared by mixing 1 μg RNAat 500 ng/μL with 3 μL of complexation medium (Opti-MEM, LifeTechnologies Corporation), and 2.5 μL of transfection reagent(Lipofectamine 2000, Life Technologies Corporation) per μg of RNA with2.5 μL of complexation medium. Diluted RNA and transfection reagent werethen mixed and incubated for 10 min at room temperature to formHigh-Concentration Liposomal RiboSlice. Alternatively, a transfectionreagent containing DOSPA or DOSPER is used.

Example 26 In Vivo RiboSlice Efficacy Study—Subcutaneous Glioma Model

40 female NCr nu/nu mice were injected subcutaneously with 1×10⁷ U-251tumor cells. Cell injection volume was 0.2 mL/mouse. The age of the miceat the start of the study was 8 to 12 weeks. A pair match was conducted,and animals were divided into 4 groups of 10 animals each when thetumors reached an average size of 35-50 mm³, and treatment was begun.Body weight was measured every day for the first 5 days, and thenbiweekly to the end of the study. Caliper measurements were madebiweekly, and tumor size was calculated. Treatment consisted ofRiboSlice BIRC5-2.1 complexed with a vehicle (Lipofectamine 2000, LifeTechnologies Corporation). To prepare the dosing solution, 294 μL ofcomplexation buffer (Opti-MEM, Life Technologies Corporation) waspipetted into a tube containing 196 μL of RiboSlice BIRC5-1.2 (500ng/μL), and the contents of the tube were mixed by pipetting. 245 μL ofcomplexation buffer was pipetted into a tube containing 245 μL ofvehicle. The contents of the second tube were mixed, and thentransferred to the first tube, and mixed with the contents of the firsttube by pipetting to form complexes. Complexes were incubated at roomtemperature for 10 min. During the incubation, syringes were loaded.Animals were injected intratumorally with a total dose of either 2 μg or5 μg RNA/animal in either 20μL or 50 μL total volume/animal. A total of5 treatments were given, with injections performed every other day.Doses were not adjusted for body weight. Animals were followed for 25days.

Example 27 Liposome Formulation and Nucleic-Acid Encapsulation

Liposomes are prepared using the following formulation: 3.2 mg/mLN-(carbonyl-ethoxypolyethylene glycol2000)-1,2-distearoyl-sn-glycero-3-phosphoethanolamine (MPEG2000-DSPE),9.6 mg/mL fully hydrogenated phosphatidylcholine, 3.2 mg/mL cholesterol,2 mg/mL ammonium sulfate, and histidine as a buffer. pH is controlledusing sodium hydroxide and isotonicity is maintained using sucrose. Toform liposomes, lipids are mixed in an organic solvent, dried, hydratedwith agitation, and sized by extrusion through a polycarbonate filterwith a mean pore size of 800 nm. Nucleic acids are encapsulated bycombining 10 μg of the liposome formulation per 1 μg of nucleic acid andincubating at room temperature for 5 minutes.

Example 28 Folate-Targeted Liposome Formulation

Liposomes are prepared according to Example 62, except that 0.27 mg/mL1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[folate(polyethyleneglycol)-5000] (FA-MPEG5000-DSPE) is added to the lipid mixture.

Example 29 Therapy Comprising Liposomal Protein-Encoding RNA

Liposomes encapsulating synthetic RNA encoding a therapeutic protein,synthesized according to Example 1, are prepared according to Example 27or Example 28. The liposomes are administered by injection orintravenous infusion.

Example 30 Generation of Elastin ivT-RNA Template

Total RNA was extracted from neonatal human dermal fibroblasts using theRNeasy mini kit (QIAGEN GmbH), according to the manufacturer'sinstructions. cDNA encoding human elastin was prepared usingMonsterScript™ Reverse Transcriptase (Epicentre Biotechnologies) and theprimer: AAAAAAACCGGT TCATTTTCTCTTCCGGCCAC. An in vitro transcription(ivT) template was prepared from the cDNA by PCR amplification of theelastin coding sequence (CDS) using the primers: F:AAAAAAGCTAGCATGGCGGGTCTGACG, and R: AAAAAAACCGGTTCATTTTCTCTTCCGGCCAC.The PCR product was then purified using agarose gel electrophoresis andthe QlAquick Gel Extraction Kit (QIAGEN GmbH) and was cloned into avector containing the human beta globin (HBB) 5′ and 3′ untranslatedregions and a strong Kozak sequence. The vector was amplified, purified,and linearized prior to RNA synthesis.

Example 31 Synthesis of Elastin RNA

RNA encoding human elastin was synthesized using the DNA template ofExample 30 and the T7 High Yield RNA Synthesis Kit (New England Biolabs,Inc.), according to the manufacturer's instructions (Table 4). Samplesof the RNA were analyzed by agarose gel electrophoresis to assess thequality of the RNA (FIG. 1). The RNA was then diluted to 200 ng/μL andan RNase inhibitor (Superase•In™, Life Technologies Corporation) wasadded at a concentration of 1 μL/200 μg of RNA. The RNA solution wasstored at 4 C.

Example 32 Production of Octanoate-Treated Human Serum Albumin

A 10% solution of HSA was pre-incubated with 16 mM sodium octanoate(Sigma-Aldrich Co. LLC), and was incubated at 37 C for 3 hours beforeassembly of the complete medium.

Example 33 Formulation for In Vivo Delivery of Nucleic Acids

The formulation for in vivo delivery of nucleic acids is prepared bycombining RNA synthesized according to Example 31 and human serumalbumin treated according to Examples 8, 9 and/or 32 in a suitablebuffer (e.g., water, DMEM/F12, complexation medium, Opti-MEM, etc.).

Example 34 Increasing Elastin Production in Skin by TransdermalInjection Via Syringe of Treated Albumin and RNA Encoding Elastin

The formulation of example 33 is loaded into an insulin syringe with a28-gauge 0.5-inch needle and delivered to the dermis of a patientthrough the epidermis. Additional doses are administered as necessary.

Example 35 Increasing Elastin Production in Skin by IntradermalInjection Via Motorized Microneedle Array of Treated Albumin and RNAEncoding Elastin

The formulation of example 33 is loaded into the chamber of a motorizedmicroneedle array set to a penetration depth of approximately 0.1 mm.The microneedle array delivers the formulation to the dermis of apatient through the epidermis.

Example 36 Increasing Collagen Production in Skin by TransdermalInjection of Treated Albumin and RNA Encoding Collagen

The formulation of example 33 is prepared using RNA encoding humancollagen type I and/or type III. The formulation is delivered as inExample 34 or 35.

Example 37 Increasing Production of Actin in Skeletal Muscle byIntramuscular Injection of Treated Albumin and RNA Encoding Actin

The formulation of example 33 is prepared using RNA encoding skeletalalpha actin. The formulation is delivered to the patient viaintramuscular injection.

Example 38 Wound Healing Treatment

The formulation of example 33 is prepared using RNA encoding basicfibroblast growth factor. The formulation is delivered as in Example 34or 35.

Example 39 Anti-Scarring Treatment

The formulation of example 33 is prepared using RNA encodingcollagenase. The formulation is delivered as in Example 34 or 35.

Example 40 Generation of Tyrosinase ivT-RNA Template

Total RNA was extracted from human epidermal melanocytes using theRNeasy mini kit (QIAGEN GmbH), according to the manufacturer'sinstructions. cDNA encoding human tyrosinase was prepared usingMonsterScript™ Reverse Transcriptase (Epicentre Biotechnologies). An invitro transcription (ivT) template was prepared from the cDNA by PCRamplification of the tyrosinase coding sequence (CDS). The PCR productwas then purified using agarose gel electrophoresis and the QIAquick GelExtraction Kit (QIAGEN GmbH) and was cloned into a vector containing thehuman beta globin (HBB) 5′ and 3′ untranslated regions and a strongKozak sequence. The vector was amplified, purified, and linearized priorto RNA synthesis.

Example 41 Synthesis of Tyrosinase RNA

RNA encoding human tyrosinase was synthesized according to Example 1,using the DNA template of Example 40 and the T7 High Yield RNA SynthesisKit (New England Biolabs, Inc.), according to the manufacturer'sinstructions (Table 4). Samples of the RNA were analyzed by agarose gelelectrophoresis to assess the quality of the RNA. The RNA was thendiluted to 1 μg/μL. The RNA solution was stored at 4 C.

Example 42 Production of Octanoate-Treated Human Serum Albumin

A 10% solution of HSA was pre-incubated with 16 mM sodium octanoate(Sigma-Aldrich Co. LLC), and was incubated at 37 C for 3 hours beforeassembly of the complete medium.

Example 43 Increasing Melanin Production in Skin by TransdermalInjection Via Syringe of RNA Encoding Tyrosinase

The RNA of Example 41 was loaded into a syringe and delivered to thedermis of the ventral forearm of a healthy 33 year-old male patient overthe course of approximately 30 seconds.

Example 44 Increasing Melanin Production in Skin by Combined Delivery ofRNA Encoding Tyrosinase and Electroporation

The area of skin treated in Example 43 was exposed to electrical pulsesof between 10V and 155V and between approximately 10 milliseconds andapproximately 1 second using a two-electrode array electricallyconnected to a capacitor. The patient reported a tingling sensation atall voltages and penetration depths. The treated area became darkerafter 24-48 hours (see FIG. 16). The experiment was repeated severaltimes, with similar results.

Example 45 Increasing Melanin Production in Skin by Topical orIntradermal Application of RNA Encoding Tyrosinase

The RNA of Example 41 or the liposomes of Example 29 are applieddirectly to the skin, with or without disruption of the stratum corneumor injected intradermally using a dose of one microgram or less persquare centimeter. Optionally, an electric field is applied as inExample 44 or using a surface-contact patch to enhance delivery of theRNA.

Example 46 Increasing Elastin Production in Skin by Transdermal Deliveryof RNA Encoding Elastin

RNA encoding elastin was prepared according to Example 1. The RNA isdelivered as in Example 43, 44 or 45.

Example 47 Increasing Collagen Production in Skin by TransdermalDelivery of RNA Encoding Collagen

RNA encoding collagen was prepared according to Example 1. The RNA isdelivered as in Example 43, 44 or 45.

Example 48 Anemia Therapy Comprising Delivery of RNA EncodingErythropoietin or Darbepoetin

RNA encoding darbepoetin alfa was prepared according to Example 1. TheRNA is delivered as in Example 43, 44 or 45.

Example 49 Increasing Production of Actin in Skeletal Muscle byIntramuscular Delivery of RNA Encoding Actin

RNA encoding actin is prepared according to Example 1. The RNA isdelivered to the patient via intramuscular injection with or without theuse of an electric field as in Example 43, 44 or 45.

Example 50 Wound Healing Treatment

RNA encoding basic fibroblast growth factor is prepared according toExample 1. The RNA is delivered as in Example 43, 44 or 45.

Example 51 Anti-Scarring Treatment

RNA encoding collagenase is prepared according to Example 1. The RNA isdelivered as in Example 43, 44 or 45.

Example 52 Production of Botulinum Toxin

RNA encoding botulinum toxin is prepared according to Example 1. The RNAis delivered as in Example 43, 44 or 45.

Example 53 Increasing Collagen Production in Skin Cells by Transfectionwith RNA Encoding Collagen I

RNA comprising the coding sequence of the human COL1A1 gene wassynthesized according to Example 1. Primary human dermal fibroblastswere plated in wells of a 24-well plate, and were transfected accordingto Example 2. Between 24 and 72 hours after transfection, the cells werefixed and stained using an antibody targeting collagen I. Manyextracellular deposits of collagen were visible in the transfected wells(FIG. 17).

Example 54 Increasing Collagen Production in Skin Cells by Transfectionwith RNA Encoding Collagen VII

RNA comprising the coding sequence of the human COL7 gene wassynthesized according to Example 1. Primary human dermal fibroblastswere plated in wells of a 24-well plate, and were transfected accordingto Example 2. Between 24 and 72 hours after transfection, the cells werefixed and stained using an antibody targeting collagen VII. Transfectedcells exhibited high levels of collagen VII, compared to anun-transfected control (FIG. 18).

Example 55 Increasing Collagen Production in Skin by TransdermalInjection via Syringe of RNA Encoding Collagen I or Collagen VII

RNA comprising the coding sequence of the human COL1A1 gene or the humanCOL7 gene was synthesized according to Example 1. The RNA is loaded intoa syringe and delivered to the dermis of a patient over the course ofapproximately 30 seconds or as in Example 43, 44 or 45.

Example 56 Increasing Collagen Production in Skin by Combined Deliveryof RNA Encoding Collagen I or Collagen VII and Electroporation

The area of skin treated in Example 55 is exposed to electrical pulsesof between 10V and 155V and between approximately 50 microseconds andapproximately 1 second using a multi-electrode array electricallyconnected to a power source.

EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain, usingno more than routine experimentation, numerous equivalents to thespecific embodiments described specifically herein. Such equivalents areintended to be encompassed in the scope of the following claims.

INCORPORATION BY REFERENCE

All patents and publications referenced herein are hereby incorporatedby reference in their entireties.

1.-9. (canceled)
 10. A method for treating a dystrophic epidermolysisbullosa patient comprising delivering to a dystrophic epidermolysisbullosa patient, in vivo or ex vivo, synthetic RNA encoding collagentype VII, to result in the amelioration of one or more of the dystrophicepidermolysis bullosa patient's symptoms.
 11. A method for treating adystrophic epidermolysis bullosa patient comprising delivering to adystrophic epidermolysis bullosa patient, in vivo or ex vivo, syntheticRNA encoding a gene-editing protein that targets the COL7 gene, toresult in the amelioration of one or more of the dystrophicepidermolysis bullosa patient's symptoms. 12.-202. (canceled)
 203. Themethod of claim 10, wherein the synthetic RNA is delivered to thepatient's skin.
 204. The method of claim 203, wherein the synthetic RNAis delivered to the patient's skin by transdermal injection.
 205. Themethod of claim 10, further comprising exposing the patient's skin toelectrical pulses.
 206. The method of claim 205, wherein the electricalpulses are between about 10V and about 155V.
 207. The method of claim205, wherein the electrical pulses are between about 50 microseconds andabout 1 second.
 208. The method of claim 10, wherein the synthetic RNAis delivered to the patient's skin cells.
 209. The method of claim 208,wherein the skin cells are fibroblasts.
 210. The method of claim 10,wherein the synthetic RNA comprises a non-canonical nucleotide selectedfrom the group consisting of 5-methyluridine, 5-hydroxyuridine,pseudouridine, 5-methylpseudouridine, 5-hydroxypseudouridine,5-methylcytidine, and 5-hydroxycytidine.
 211. The method of claim 210,wherein the synthetic RNA comprises 5-hydroxymethylcytidine.
 212. Themethod of claim 210, wherein the synthetic RNA comprises 5-methyluridineat about 40% of the uridine residues.
 213. The method of claim 10,wherein the collagen type VII is collagen type VII (A1).
 214. The methodof claim 10, wherein the synthetic RNA encodes the amino acid sequenceof SEQ ID NO:
 78. 215. The method of claim 10, further resulting inincreased expression of collagen type VII within between about 24 andabout 72 hours of delivery.
 216. The method of claim 10, wherein thesynthetic RNA encodes the coding sequence of the human COL7 gene. 217.The method of claim 11, wherein the synthetic RNA is delivered to thepatient's skin.
 218. The method of claim 11, wherein the gene-editingprotein corrects or eliminates, either alone or in combination with oneor more other molecules or gene-editing proteins, a mutation that is atleast partially responsible for a disease phenotype.
 219. The method ofclaim 11, wherein the synthetic RNA is delivered to the patient's skincells.
 220. The method of claim 219, wherein the skin cells arefibroblasts.
 221. The method of claim 11, wherein the synthetic RNAcomprises a non-canonical nucleotide selected from the group consistingof 5-methyluridine, 5-hydroxyuridine, pseudouridine,5-methylpseudouridine, 5-hydroxypseudouridine, 5-methylcytidine, and5-hydroxycytidine.
 222. The method of claim 11, further comprisingdelivering a repair template to the patient.
 223. The method of claim222, wherein the repair template is a single-stranded DNA molecule or adouble-stranded DNA molecule.
 224. The method of claim 222, wherein therepair template does not contain a binding site of the gene-editingprotein.
 225. The method of claim 224, wherein the repair templateencodes an amino-acid sequence that is encoded by a DNA sequence thatcomprises a binding site of the gene-editing protein.
 226. The method ofclaim 11, wherein the gene-editing protein targets a nucleic acidsequence that encodes the amino acid sequence of SEQ ID NO:
 78. 227. Themethod of claim 11, wherein the gene-editing protein is selected fromthe group consisting of a nuclease, a transcription activator-likeeffector nuclease (TALEN), a zinc-finger nuclease, a meganuclease, anickase, and a clustered regularly interspaced short palindromic repeat(CRISPR)-associated protein.
 228. The method of claim 11, furtherresulting in editing of the COL7 gene.